Healthcare Provider Details

I. General information

NPI: 1295842219
Provider Name (Legal Business Name): CAPITAL FAMILY PHYSICIANS PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 11/23/2020
Certification Date: 11/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

#4 HMB CIRCLE
FRANKFORT KY
40601
US

IV. Provider business mailing address

PO BOX 4168
FRANKFORT KY
40604-4168
US

V. Phone/Fax

Practice location:
  • Phone: 502-695-7725
  • Fax: 502-695-7848
Mailing address:
  • Phone: 502-223-5811
  • Fax: 502-227-7379

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateKY

VIII. Authorized Official

Name: STEVEN CRUM
Title or Position: PRESIDENT
Credential: MD
Phone: 502-695-7725