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101 Old Fort Rd Stanford KY 40484-8540 | |
(606) 365-2191 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Student Health |
Location | 101 Old Fort Rd, Stanford, Kentucky |
Authorized Official Name and Position | Diane Miller (PUBLIC HEALTH ADMINISTRATOR) |
Authorized Official Contact | 6063653106 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 265 305 Danville Ave Stanford KY 40484-0265 Ph: (606) 365-7287 | 101 Old Fort Rd Stanford KY 40484-8540 Ph: (606) 365-2191 |
NPI Number | 1063534196 |
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Provider Enumeration Date | 04/06/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
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1063534196 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QS1000X | Clinic/center - Student Health | (* (Not Available)) | Primary |