Healthcare Provider Details

I. General information

NPI: 1932871266
Provider Name (Legal Business Name): MY TURNING POINT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2021
Last Update Date: 10/22/2021
Certification Date: 10/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

934 STANFORD ST
STANFORD KY
40484
US

IV. Provider business mailing address

235 STOKELY RD
CYNTHIANA KY
41031-2104
US

V. Phone/Fax

Practice location:
  • Phone: 606-661-0278
  • Fax: 606-661-0413
Mailing address:
  • Phone: 859-954-5150
  • Fax: 859-954-5160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DWAYNE HAY
Title or Position: MEMBER/OWNER
Credential:
Phone: 502-387-4442