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General NPI Number Information
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NPI Number | 1386792067
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Entity Type | Organization
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Legal Business Name | M2K INTERNAL MEDICINE, PLLC
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 120 N EAGLE CREEK DR SUITE 321
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City | LEXINGTON
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State | KY
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Zip | 40509-1827
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Country | US
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Telephone | 859-233-1490
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Fax | 859-264-8026
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Provider Business Mailing Address
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Address Line | 120 N EAGLE CREEK DR SUITE 321
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City | LEXINGTON
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State | KY
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Zip | 40509-1827
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Country | US
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Telephone | 859-233-1490
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Fax | 859-264-8026
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Authorized Official
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Title or Position | MANAGER
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Name | DR. CHARLES G GRIGSBY
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Credential | MD
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Telephone | 859-233-1490
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 13046
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License Number State | KY
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