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415 Highway 610 West Suite 100 Virgie KY 41572 | |
(606) 639-0855 | |
Not Available |
Full Name | |
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Speciality | Clinic/center |
Location | 415 Highway 610 West Suite 100, Virgie, Kentucky |
Authorized Official Name and Position | Christopher D. Knight (EXEC. V.P. / CFO) |
Authorized Official Contact | 4232308200 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1 Medical Park Blvd Bristol TN 37620-7430 Ph: (423) 844-4711 | 415 Highway 610 West Suite 100 Virgie KY 41572 Ph: (606) 639-0855 |
NPI Number | 1184812174 |
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Provider Enumeration Date | 10/04/2007 |
Last Update Date | 11/12/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1184812174 | NPI | - | NPPES |
31000896 | Medicaid | KY |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (* (Not Available)) | Primary |