Healthcare Provider Details

I. General information

NPI: 1881749927
Provider Name (Legal Business Name): EPHRAIM MCDOWELL HEALTH RESOURCE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 10/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 LINCOLN DRIVE
SPRINGFIELD KY
40069-1516
US

IV. Provider business mailing address

PO BOX 990
DANVILLE KY
40423-0990
US

V. Phone/Fax

Practice location:
  • Phone: 859-336-9801
  • Fax: 859-336-3080
Mailing address:
  • Phone: 859-239-2360
  • Fax: 859-239-6898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number900140
License Number StateKY

VIII. Authorized Official

Name: WILLIAM M SNAPP III
Title or Position: CFO
Credential:
Phone: 859-239-1000