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General NPI Number Information
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NPI Number | 1023019130
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Entity Type | Organization
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Legal Business Name | MS COMMUNITY HEALTH LLC
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Dates
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Enumeration Date | 08/10/2005
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Last Update Date | 12/18/2007
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Provider Practice Location Address
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Address Line | 1010 MEDICAL CENTER DRIVE
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City | POWDERLY
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State | KY
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Zip | 42367
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Country | US
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Telephone | 270-377-1600
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Fax | 270-388-0229
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Provider Business Mailing Address
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Address Line | 1010 MEDICAL CENTER DRIVE
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City | POWDERLY
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State | KY
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Zip | 42367
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Country | US
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Telephone | 270-377-1600
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Fax | 270-388-0229
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. THOMAS RANDALL POWELL
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Credential |
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Telephone | 270-377-1650
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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