| Smith's Hometown Family Practice, Llc | |
|
359 Old Us Highway 421 Manchester KY 40962-7538 | |
| (606) 599-8905 | |
| (606) 599-0354 |
| Full Name | Smith's Hometown Family Practice, Llc |
|---|---|
| Speciality | Clinic/center |
| Location | 359 Old Us Highway 421, Manchester, Kentucky |
| Authorized Official Name and Position | Shawana M.l. Smith (OWNER) |
| Authorized Official Contact | 6065998905 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Smith's Hometown Family Practice, Llc 359 Old Us Highway 421 Manchester KY 40962-7538 Ph: (606) 599-8905 | Smith's Hometown Family Practice, Llc 359 Old Us Highway 421 Manchester KY 40962-7538 Ph: (606) 599-8905 |
| NPI Number | 1275934614 |
|---|---|
| Provider Enumeration Date | 09/04/2014 |
| Last Update Date | 09/04/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275934614 | NPI | - | NPPES |
| 7100100870 | Medicaid | KY | |
| 11996475 | Other | KY | CAQH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 3006073 (Kentucky) | Primary |
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