| Owensboro Health Twin Lakes Medical Center Family Medicine | |
|
301 Sunset Dr Caneyville KY 42721-9172 | |
| (270) 879-3711 | |
| Not Available |
| Full Name | Owensboro Health Twin Lakes Medical Center Family Medicine |
|---|---|
| Speciality | Clinic/Center |
| Location | 301 Sunset Dr, Caneyville, Kentucky |
| Authorized Official Name and Position | Russell S Ranallo (VICE PRESIDENT OF FINANCE) |
| Authorized Official Contact | 2706857180 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Owensboro Health Twin Lakes Medical Center Family Medicine Po Box 23229 Owensboro KY 42304-3229 Ph: (270) 688-1330 | Owensboro Health Twin Lakes Medical Center Family Medicine 301 Sunset Dr Caneyville KY 42721-9172 Ph: (270) 879-3711 |
| NPI Number | 1346846268 |
|---|---|
| Provider Enumeration Date | 12/07/2020 |
| Last Update Date | 12/07/2022 |
| Medicare PECOS PAC ID | 3779996558 |
|---|---|
| Medicare Enrollment ID | O20210128002561 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346846268 | NPI | - | NPPES |
| 7100734490 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Grayson County Hospital Foundation Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 301 Sunset Dr, Caneyville, KY 42721 Phone: 270-879-3711 Fax: 270-879-8674 |