Healthcare Provider Details

I. General information

NPI: 1205092640
Provider Name (Legal Business Name): AFTER HOURS FAMILY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2008
Last Update Date: 12/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

274 CASSIDY BLVD
PIKEVILLE KY
41501-1544
US

IV. Provider business mailing address

PO BOX 4028
PIKEVILLE KY
41502-4028
US

V. Phone/Fax

Practice location:
  • Phone: 606-437-4050
  • Fax: 606-478-4288
Mailing address:
  • Phone: 606-437-4050
  • Fax: 606-478-4288

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 Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: LINDA WILLIAMS
Title or Position: BILLING DIRECTOR
Credential:
Phone: 606-478-4287