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2200 E Parrish Ave Bldg C Ste 104 Owensboro KY 42303-1449 | |
| (270) 852-1632 | |
| (270) 852-1633 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 2200 E Parrish Ave, Owensboro, Kentucky |
| Authorized Official Name and Position | Danett J Keown (OFFICE MANAGER) |
| Authorized Official Contact | 2708521632 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2200 E Parrish Ave Bldg C Ste 104 Owensboro KY 42303-1449 Ph: (270) 852-1632 | 2200 E Parrish Ave Bldg C Ste 104 Owensboro KY 42303-1449 Ph: (270) 852-1632 |
| NPI Number | 1407924806 |
|---|---|
| Provider Enumeration Date | 12/01/2006 |
| Last Update Date | 04/20/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407924806 | NPI | - | NPPES |
| C64949 | Other | UPIN | |
| 331024 | Other | KY | ANTHEM |
| 6417376880 | Medicaid | KY | |
| 363734 | Other | ANTHEM | |
| 95003349 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 17376 (Kentucky) | Primary |
| 363A00000X | Physician Assistant | PA 340 (Kentucky) | Secondary |
| 363A00000X | Physician Assistant | PA 334 (Kentucky) | Secondary |
Jones Medical Corp Dba Bridgewater Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 750 Salem Drive, Owensboro, KY 42303 Phone: 270-686-8008 Fax: 270-686-8066 | |
Choice Care Associates, Psc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1000 Breckenridge St, Suite 400, Owensboro, KY 42303 Phone: 270-688-0900 Fax: 207-926-7488 | |
Randy L Wolfe, Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1325 Triplett St, Owensboro, KY 42303 Phone: 270-688-4325 | |
Robert C Dalzell,md Psc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2816 Veach Rd, Owensboro, KY 42303 Phone: 270-926-2929 Fax: 270-683-3290 |