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General NPI Number Information
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NPI Number | 1164708327
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Entity Type | Organization
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Legal Business Name | TOTAL ACCESS PHYSICIANS, P.S.C.
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Dates
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Enumeration Date | 11/01/2011
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Last Update Date | 11/01/2011
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Provider Practice Location Address
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Address Line | 1838 FLORENCE PIKE
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City | BURLINGTON
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State | KY
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Zip | 41005
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Country | US
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Telephone | 859-409-4591
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 861
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City | BURLINGTON
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State | KY
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Zip | 41005-0861
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Country | US
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Telephone | 859-409-4591
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JERRY LEE TOLBERT
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Credential | M.D.
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Telephone | 859-409-4591
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | KY
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