Healthcare Provider Details

I. General information

NPI: 1407382104
Provider Name (Legal Business Name): CHERAH JADE PRYCE D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2017
Last Update Date: 03/06/2024
Certification Date: 03/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

911 BYPASS RD BLDG D
PIKEVILLE KY
41501-1602
US

IV. Provider business mailing address

PO BOX 432
PIKEVILLE KY
41502-0432
US

V. Phone/Fax

Practice location:
  • Phone: 606-430-3500
  • Fax: 606-432-6762
Mailing address:
  • Phone: 606-430-3500
  • Fax: 606-432-6762

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number05080
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: