| Unbridled Healthcare System Llc | |
|
220 N Main St London KY 40741-1367 | |
| (606) 770-3014 | |
| Not Available |
| Full Name | Unbridled Healthcare System Llc |
|---|---|
| Speciality | General Practice |
| Location | 220 N Main St, London, Kentucky |
| Authorized Official Name and Position | Terri Tye (BILLING AND CREDENTIALING) |
| Authorized Official Contact | 6062153832 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Unbridled Healthcare System Llc Po Box 2448 London KY 40743-2448 Ph: (606) 770-3014 | Unbridled Healthcare System Llc 220 N Main St London KY 40741-1367 Ph: (606) 770-3014 |
| NPI Number | 1295461663 |
|---|---|
| Provider Enumeration Date | 07/28/2022 |
| Last Update Date | 10/11/2023 |
| Medicare PECOS PAC ID | 3274919097 |
|---|---|
| Medicare Enrollment ID | O20221003001081 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295461663 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| Provider Name | Francine Robinson Mosley |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1215952544 PECOS PAC ID: 3678519824 Enrollment ID: I20091013000611 |
| Provider Name | David Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356622419 PECOS PAC ID: 8820261332 Enrollment ID: I20111028000221 |
| Provider Name | Douglas Blake Saylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295505295 PECOS PAC ID: 7416499942 Enrollment ID: I20240611004334 |
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