Healthcare Provider Details

I. General information

NPI: 1386632701
Provider Name (Legal Business Name): SCOTT COUNTY FAMILY PHYSICIANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2005
Last Update Date: 02/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 BEVINS LN STE C
GEORGETOWN KY
40324-6120
US

IV. Provider business mailing address

210 BEVINS LN STE C
GEORGETOWN KY
40324-6120
US

V. Phone/Fax

Practice location:
  • Phone: 502-868-0622
  • Fax: 502-868-9097
Mailing address:
  • Phone: 502-868-0622
  • Fax: 502-868-9097

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. BRETT A OLIVER
Title or Position: OWNER
Credential: MD
Phone: 502-868-0622