Healthcare Provider Details

I. General information

NPI: 1124547757
Provider Name (Legal Business Name): SCIENCE HILL FAMILY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2017
Last Update Date: 12/17/2019
Certification Date: 12/17/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5775 N HIGHWAY 27 STE 6
SCIENCE HILL KY
42553-9140
US

IV. Provider business mailing address

5775 N HIGHWAY 27 STE 6
SCIENCE HILL KY
42553-9140
US

V. Phone/Fax

Practice location:
  • Phone: 606-685-6131
  • Fax: 606-685-6179
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TONYA OAKLEY
Title or Position: OFFICE MANAGER
Credential:
Phone: 606-685-6131