Healthcare Provider Details

I. General information

NPI: 1568745024
Provider Name (Legal Business Name): A & A CLINICS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2011
Last Update Date: 02/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 E COLLEGE AVE
STANTON KY
40380-2317
US

IV. Provider business mailing address

700 E COLLEGE AVE
STANTON KY
40380-2317
US

V. Phone/Fax

Practice location:
  • Phone: 606-693-0199
  • Fax: 606-666-9480
Mailing address:
  • Phone: 606-693-0199
  • Fax: 606-666-9480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number34645
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. MELECIO G ABORDO JR.
Title or Position: CO-OWNER
Credential: M.D.
Phone: 606-693-0199