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General NPI Number Information
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NPI Number | 1396802203
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Entity Type | Organization
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Legal Business Name | DIX RIVER FAMILY MEDICINE AND WOMEN'S HEALTH GROU-P
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Dates
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Enumeration Date | 01/02/2007
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Last Update Date | 10/04/2023
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Provider Practice Location Address
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Address Line | 100 JAY ST
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City | STANFORD
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State | KY
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Zip | 40484-7511
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Country | US
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Telephone | 606-365-1547
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Fax | 606-365-8380
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Provider Business Mailing Address
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Address Line | PO BOX 330
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City | STANFORD
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State | KY
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Zip | 40484-0330
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Country | US
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Telephone | 606-365-1547
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Fax | 606-365-8380
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Authorized Official
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Title or Position | PHYSICIAN AND CO-OWNER
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Name | DR. CHRISTOPHER DUVALL SIMS
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Credential | MD
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Telephone | 606-365-1547
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 3219P
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License Number State | KY
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