| Ourphonemd | |
|
103 Financial Pl Ste 300 Elizabethtown KY 42701-4470 | |
| (270) 600-0136 | |
| Not Available |
| Full Name | Ourphonemd |
|---|---|
| Speciality | Clinic/Center |
| Location | 103 Financial Pl Ste 300, Elizabethtown, Kentucky |
| Authorized Official Name and Position | Yasir Saifullah (OWNER) |
| Authorized Official Contact | 2706000136 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ourphonemd 103 Financial Pl Ste 300 Elizabethtown KY 42701-4470 Ph: (270) 600-0136 | Ourphonemd 103 Financial Pl Ste 300 Elizabethtown KY 42701-4470 Ph: (270) 600-0136 |
| NPI Number | 1952929689 |
|---|---|
| Provider Enumeration Date | 07/09/2020 |
| Last Update Date | 09/22/2020 |
| Medicare PECOS PAC ID | 2163840117 |
|---|---|
| Medicare Enrollment ID | O20200908003074 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952929689 | NPI | - | NPPES |
| 7100676730 | Other | KY | KY MEDICAID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Primary |
| Provider Name | Heather L Hans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770095127 PECOS PAC ID: 4284990664 Enrollment ID: I20171117003100 |
| Provider Name | Yasir Saifullah |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023056959 PECOS PAC ID: 8224129010 Enrollment ID: I20200909002476 |
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