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General NPI Number Information
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NPI Number | 1366756736
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Entity Type | Organization
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Legal Business Name | MOUNT STERLING FAMILY CARE CENTER PLLC
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Dates
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Enumeration Date | 07/28/2010
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Last Update Date | 09/02/2010
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Provider Practice Location Address
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Address Line | 1107 INDIAN MOUND DR STE D
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City | MOUNT STERLING
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State | KY
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Zip | 40353-1300
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Country | US
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Telephone | 270-871-7735
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Fax |
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Provider Business Mailing Address
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Address Line | 112 GORING LN
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City | FRANKFORT
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State | KY
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Zip | 40601-7000
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Country | US
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Telephone | 270-871-7735
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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. BHAWAN N YAMRAJ
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Credential | MD
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Telephone | 270-871-7735
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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 | 38038
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License Number State | KY
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