Healthcare Provider Details

I. General information

NPI: 1922102946
Provider Name (Legal Business Name): ANDERSON FAMILY HEALTH CARE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2006
Last Update Date: 12/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 AMSDEN AVE STE 301
VERSAILLES KY
40383-1851
US

IV. Provider business mailing address

360 AMSDEN AVE STE 301
VERSAILLES KY
40383-1851
US

V. Phone/Fax

Practice location:
  • Phone: 859-873-1303
  • Fax:
Mailing address:
  • Phone: 859-873-1303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number29823
License Number StateKY

VIII. Authorized Official

Name: CURTIS WELLING
Title or Position: PA
Credential:
Phone: 859-873-1303