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General NPI Number Information
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NPI Number | 1003583717
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Entity Type | Organization
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Legal Business Name | COMMONWEALTH FAMILY CLINIC, PLLC
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Dates
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Enumeration Date | 08/30/2021
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Last Update Date | 12/08/2023
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Provider Practice Location Address
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Address Line | 2387 PROFESSIONAL HEIGHTS DR STE 60
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City | LEXINGTON
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State | KY
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Zip | 40503-3004
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Country | US
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Telephone | 859-303-8756
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Fax |
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Provider Business Mailing Address
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Address Line | 1890 STAR SHOOT PKWY STE 170
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City | LEXINGTON
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State | KY
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Zip | 40509-4567
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Country | US
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Telephone | 859-457-1864
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Fax |
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Authorized Official
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Title or Position | OWNER, EMPLOYEE
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Name | MRS. ANNE CLAIRE COMPTON
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Credential | APRN
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Telephone | 859-457-1864
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QX0100X
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Taxonomy Name | Occupational Medicine Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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