MEDICARE: UNITED CLINICS OF KENTUCKY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR1300X	Rural Health Clinic/Center

General Provider Information

NPI Number	:	1386425684
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNITED CLINICS OF KENTUCKY LLC

Provider Business Mailing Address
First Line	:	PO BOX 220
Second Line	:
City	:	WINCHESTER
State	:	KY
Zip	:	40392-0220
Country	:	US
Telephone Number	:	606-668-3120
Fax Number	:	606-668-3125

Provider Business Practice Location Address
First Line	:	95 JACKSON HTS STE A
Second Line	:
City	:	JACKSON
State	:	KY
Zip	:	41339-6500
Country	:	US
Telephone Number	:	606-718-6505
Fax Number	:	606-272-6180

Authorized Official
Title or Position	:	OWNER
Name	:	NADEEM SHAIKH
Credential	:	MD
Telephone Number	:	606-668-3120

Provider Enumeration Date	:	10/12/2023
Last Update Date	:	10/12/2023

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