Stephanie N. Southard, Psc | |
1215 N Main St Suite 2 Monticello KY 42633-2900 | |
(606) 340-8825 | |
(606) 340-0097 |
Full Name | Stephanie N. Southard, Psc |
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Speciality | Clinic/center - Primary Care |
Location | 1215 N Main St, Monticello, Kentucky |
Authorized Official Name and Position | Stephanie Nicole Southard (PRESIDENT) |
Authorized Official Contact | 6063408825 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Stephanie N. Southard, Psc 1215 N Main St Suite 2 Monticello KY 42633-2900 Ph: (606) 340-8825 | Stephanie N. Southard, Psc 1215 N Main St Suite 2 Monticello KY 42633-2900 Ph: (606) 340-8825 |
NPI Number | 1629267315 |
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Provider Enumeration Date | 10/18/2007 |
Last Update Date | 06/03/2010 |
Identifier | Type | State | Issuer |
---|---|---|---|
1629267315 | NPI | - | NPPES |
64061807 | Medicaid | KY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | 02809 (Kentucky) | Primary |
363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |