Healthcare Provider Details

I. General information

NPI: 1669803375
Provider Name (Legal Business Name): EPHRAIM MCDOWELL HEALTH RESOURCE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2013
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 PONDER CT
DANVILLE KY
40422-9050
US

IV. Provider business mailing address

105 PONDER CT
DANVILLE KY
40422-9050
US

V. Phone/Fax

Practice location:
  • Phone: 859-236-4216
  • Fax:
Mailing address:
  • Phone: 859-236-4216
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MR. DANIEL MCKAY
Title or Position: CEO
Credential:
Phone: 859-239-1000