| St. Elizabeth Center For Family Medicine | |
|
413 S Loop Rd Edgewood KY 41017-5446 | |
| (859) 301-3800 | |
| (859) 301-3987 |
| Full Name | St. Elizabeth Center For Family Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 413 S Loop Rd, Edgewood, Kentucky |
| Authorized Official Name and Position | Timothy Gramann (DIRECTOR FAMILY PRACTICE CENTER ADM) |
| Authorized Official Contact | 8593013800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| St. Elizabeth Center For Family Medicine 413 S Loop Rd Edgewood KY 41017-5446 Ph: (859) 301-3800 | St. Elizabeth Center For Family Medicine 413 S Loop Rd Edgewood KY 41017-5446 Ph: (859) 301-3800 |
| NPI Number | 1710001185 |
|---|---|
| Provider Enumeration Date | 03/19/2007 |
| Last Update Date | 12/29/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710001185 | NPI | - | NPPES |
| 65901688 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Kentucky) | Primary |
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