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General NPI Number Information
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NPI Number | 1578230124
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Entity Type | Organization
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Legal Business Name | INFINITY FAMILY CARE, PLLC
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Dates
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Enumeration Date | 08/23/2021
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Last Update Date | 08/23/2021
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Provider Practice Location Address
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Address Line | 104 COMMERCE ST
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City | CADIZ
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State | KY
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Zip | 42211-9780
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Country | US
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Telephone | 270-512-2512
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1039
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City | CADIZ
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State | KY
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Zip | 42211-1039
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Country | US
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Telephone | 270-512-2512
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Fax |
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Authorized Official
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Title or Position | OWNEE
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Name | JEANINE WADLINGTON
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Credential | APRN
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Telephone | 270-512-2512
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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 |
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License Number State |
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