Healthcare Provider Details

I. General information

NPI: 1871526780
Provider Name (Legal Business Name): GARRARD CLINIC PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 05/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 DANVILLE ST
LANCASTER KY
40444-1150
US

IV. Provider business mailing address

870 CORPORATE DR SUITE 400
LEXINGTON KY
40503-5416
US

V. Phone/Fax

Practice location:
  • Phone: 859-792-2124
  • Fax:
Mailing address:
  • Phone: 859-277-9436
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: BRENDA HARDWICK
Title or Position: OFFICE MANAGER
Credential:
Phone: 859-792-2124