Healthcare Provider Details

I. General information

NPI: 1457468969
Provider Name (Legal Business Name): REGIONAL PHYSICIANS CORPORATION II
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2006
Last Update Date: 11/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1934 BYPASS RD
WINCHESTER KY
40391-2389
US

IV. Provider business mailing address

PO BOX 4140
WINCHESTER KY
40392-4140
US

V. Phone/Fax

Practice location:
  • Phone: 859-745-1160
  • Fax: 859-745-7789
Mailing address:
  • Phone: 859-745-6471
  • Fax: 859-744-0257

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number700085
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MR. ROBERT DONALD FRARACCIO
Title or Position: CEO
Credential:
Phone: 859-745-3500