Prospect Health And Community Llc | |
1035 Wall St Ste 206 Jeffersonville IN 47130-3694 | |
(859) 443-6697 | |
Not Available |
Full Name | Prospect Health And Community Llc |
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Speciality | Family Medicine |
Location | 1035 Wall St Ste 206, Jeffersonville, Indiana |
Authorized Official Name and Position | Anas Alzuhaili (OWNER) |
Authorized Official Contact | 8594436697 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Prospect Health And Community Llc 5804 Tee View Ct Prospect KY 40059-8555 Ph: () - | Prospect Health And Community Llc 1035 Wall St Ste 206 Jeffersonville IN 47130-3694 Ph: (859) 443-6697 |
NPI Number | 1689404741 |
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Provider Enumeration Date | 08/05/2024 |
Last Update Date | 08/05/2024 |
Medicare PECOS PAC ID | 7517498199 |
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Medicare Enrollment ID | O20241007003182 |
Identifier | Type | State | Issuer |
---|---|---|---|
1689404741 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Denise B Wilburn |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1417984758 PECOS PAC ID: 0941205439 Enrollment ID: I20140814000105 |
Provider Name | Anas Alzuhaili |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1417188491 PECOS PAC ID: 1759535792 Enrollment ID: I20180115000281 |
Provider Name | Amanda Wiley |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1326542820 PECOS PAC ID: 6800158999 Enrollment ID: I20210805003532 |
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