| Providence Medical Llc | |
|
424 Lewis Hargett Cir Ste 250 Lexington KY 40503-3687 | |
| (803) 240-2847 | |
| Not Available |
| Full Name | Providence Medical Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 424 Lewis Hargett Cir Ste 250, Lexington, Kentucky |
| Authorized Official Name and Position | Amy Mckissick (NURSE PRACTITIONER) |
| Authorized Official Contact | 8032402847 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Medical Llc 1301 Summerville Ave Columbia SC 29201-1927 Ph: (803) 240-2847 | Providence Medical Llc 424 Lewis Hargett Cir Ste 250 Lexington KY 40503-3687 Ph: (803) 240-2847 |
| NPI Number | 1871312918 |
|---|---|
| Provider Enumeration Date | 10/07/2024 |
| Last Update Date | 10/07/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871312918 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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