| South Main Clinic Llc | |
|
1913 S Main St Madisonville KY 42431-3353 | |
| (270) 404-3411 | |
| Not Available |
| Full Name | South Main Clinic Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1913 S Main St, Madisonville, Kentucky |
| Authorized Official Name and Position | James Bradley Ashby (VICE-PRESIDENT/MEMBER) |
| Authorized Official Contact | 2704043411 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| South Main Clinic Llc 1913 S Main St Madisonville KY 42431-3353 Ph: (270) 404-3411 | South Main Clinic Llc 1913 S Main St Madisonville KY 42431-3353 Ph: (270) 404-3411 |
| NPI Number | 1851959217 |
|---|---|
| Provider Enumeration Date | 05/31/2019 |
| Last Update Date | 07/01/2020 |
| Medicare PECOS PAC ID | 4082048483 |
|---|---|
| Medicare Enrollment ID | O20191217002951 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851959217 | NPI | - | NPPES |
| 1851959217 | Other | NPI |
| Provider Name | Barton K Spurlin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619917796 PECOS PAC ID: 0446215180 Enrollment ID: I20061115000298 |
| Provider Name | Kristy Mcintosh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750611521 PECOS PAC ID: 6608039573 Enrollment ID: I20120514000349 |
| Provider Name | Amy Jo Haynie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285764829 PECOS PAC ID: 9133359086 Enrollment ID: I20200117002371 |
| Provider Name | Emily Floyd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619503836 PECOS PAC ID: 3870923006 Enrollment ID: I20200430001268 |
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