| Sugar Doctor | |
|
132 Kieta Way Radcliff KY 40160-2105 | |
| (270) 748-1110 | |
| (270) 220-0531 |
| Full Name | Sugar Doctor |
|---|---|
| Speciality | Internal Medicine |
| Location | 132 Kieta Way, Radcliff, Kentucky |
| Authorized Official Name and Position | Sarah Sheldon (MEDICAL CODER AND BILLER) |
| Authorized Official Contact | 2707481110 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sugar Doctor 132 Kieta Way Radcliff KY 40160-2105 Ph: (270) 748-1110 | Sugar Doctor 132 Kieta Way Radcliff KY 40160-2105 Ph: (270) 748-1110 |
| NPI Number | 1609420272 |
|---|---|
| Provider Enumeration Date | 07/31/2019 |
| Last Update Date | 04/12/2024 |
| Medicare PECOS PAC ID | 3274955224 |
|---|---|
| Medicare Enrollment ID | O20200619000807 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609420272 | NPI | - | NPPES |
| 7100331710 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | (* (Not Available)) | Primary |
| Provider Name | Brian C Brill |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447539663 PECOS PAC ID: 3678707155 Enrollment ID: I20150115001386 |
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