Healthcare Provider Details

I. General information

NPI: 1710664263
Provider Name (Legal Business Name): EPHRAIM MCDOWELL HEALTH RESOURCE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2023
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 E LEXINGTON AVE STE B
DANVILLE KY
40422-1719
US

IV. Provider business mailing address

PO BOX 990
DANVILLE KY
40423-0990
US

V. Phone/Fax

Practice location:
  • Phone: 859-239-4950
  • Fax: 859-239-4959
Mailing address:
  • Phone: 859-239-2318
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
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: 859-239-2410