=====================================================
General NPI Number Information
=====================================================
NPI Number | 1740104439
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PIKEVILLE MEDICAL CENTER INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/06/2026
-----------------------------------------------------
Last Update Date | 08/06/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 723 S LAKE DR
-----------------------------------------------------
City | PRESTONSBURG
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 41653-1340
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 606-430-2256
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 2917
-----------------------------------------------------
City | PIKEVILLE
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 41502-2917
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 606-430-9753
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | SUMMER JOHNSON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 606-430-9753
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QP2300X
-----------------------------------------------------
Taxonomy Name | Primary Care Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 261QU0200X
-----------------------------------------------------
Taxonomy Name | Urgent Care Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------