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110 Metker Trl Stanford KY 40484-1020 | |
(606) 365-3360 | |
Not Available |
Full Name | |
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Speciality | Family Medicine |
Location | 110 Metker Trl, Stanford, Kentucky |
Authorized Official Name and Position | Amanda J Kinman (CFO) |
Authorized Official Contact | 8592392424 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 990 Danville KY 40423-0990 Ph: (859) 239-2360 | 110 Metker Trl Stanford KY 40484-1020 Ph: (606) 365-3360 |
NPI Number | 1205328895 |
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Provider Enumeration Date | 05/31/2018 |
Last Update Date | 12/30/2021 |
Medicare PECOS PAC ID | 7416842364 |
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Medicare Enrollment ID | O20180710001664 |
Identifier | Type | State | Issuer |
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1205328895 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |