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General NPI Number Information
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NPI Number | 1801602214
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Entity Type | Organization
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Legal Business Name | FAMILYFIRST MEDICINE, LLC
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Dates
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Enumeration Date | 12/10/2024
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Last Update Date | 04/08/2025
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Provider Practice Location Address
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Address Line | 933 29TH ST
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City | ASHLAND
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State | KY
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Zip | 41101-3021
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Country | US
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Telephone | 606-205-8768
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Fax |
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Provider Business Mailing Address
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Address Line | 933 29TH ST
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City | ASHLAND
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State | KY
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Zip | 41101-3021
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Country | US
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Telephone | 606-393-1115
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Fax | 606-393-1107
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Authorized Official
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Title or Position | OWNER
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Name | GABRIEL JACOB HENDERSON
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Credential |
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Telephone | 502-514-6040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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