| Village Medical | |
|
325 W Walnut St Ste 600 Lebanon KY 40033-1378 | |
| (270) 699-9500 | |
| (270) 699-9550 |
| Full Name | Village Medical |
|---|---|
| Speciality | Clinic/Center |
| Location | 325 W Walnut St Ste 600, Lebanon, Kentucky |
| Authorized Official Name and Position | Clive K Fields (OWNER) |
| Authorized Official Contact | 2706999500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Village Medical 125 S Clark St Ste 900 Chicago IL 60603-4043 Ph: (844) 969-0686 | Village Medical 325 W Walnut St Ste 600 Lebanon KY 40033-1378 Ph: (270) 699-9500 |
| NPI Number | 1063120194 |
|---|---|
| Provider Enumeration Date | 11/08/2022 |
| Last Update Date | 12/06/2022 |
| Medicare PECOS PAC ID | 6709119068 |
|---|---|
| Medicare Enrollment ID | O20230517001582 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063120194 | NPI | - | NPPES |
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