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General NPI Number Information
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NPI Number | 1104282482
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Entity Type | Organization
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Legal Business Name | WEBB PRIMARY CARE LLC
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Dates
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Enumeration Date | 01/03/2016
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Last Update Date | 01/03/2016
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Provider Practice Location Address
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Address Line | 419 TOWN MOUNTAIN RD SUITE 203
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City | PIKEVILLE
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State | KY
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Zip | 41501-1631
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Country | US
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Telephone | 606-253-3003
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Fax | 606-253-3002
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Provider Business Mailing Address
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Address Line | 419 TOWN MOUNTAIN RD SUITE 203
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City | PIKEVILLE
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State | KY
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Zip | 41501-1631
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Country | US
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Telephone | 606-253-3003
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Fax | 606-253-3002
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Authorized Official
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Title or Position | OWNER
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Name | MRS. GINGER WEBB
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Credential | APRN
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Telephone | 606-253-3003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 3008661
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License Number State | KY
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