MEDICARE: RICHMOND PRIMARY CARE, PLLC

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	261QP2300X	Primary Care Clinic/Center	36218	KY

General Provider Information

NPI Number	:	1861750838
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RICHMOND PRIMARY CARE, PLLC

Provider Business Mailing Address
First Line	:	1024 IVAL JAMES BLVD STE B
Second Line	:
City	:	RICHMOND
State	:	KY
Zip	:	40475-7622
Country	:	US
Telephone Number	:	859-353-8041
Fax Number	:	859-353-8042

Provider Business Practice Location Address
First Line	:	1024 IVAL JAMES BLVD STE B
Second Line	:
City	:	RICHMOND
State	:	KY
Zip	:	40475-7622
Country	:	US
Telephone Number	:	859-353-8041
Fax Number	:	859-353-8042

Authorized Official
Title or Position	:	MEDICAL DOCTOR
Name	:	DR. NUZHAT NAQVI
Credential	:
Telephone Number	:	859-353-8041

Provider Enumeration Date	:	04/27/2012
Last Update Date	:	02/02/2023

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