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General NPI Number Information
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NPI Number | 1982659496
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Entity Type | Organization
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Legal Business Name | ANDERSON PRIMARY CARE LLC
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Dates
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Enumeration Date | 05/23/2006
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Last Update Date | 10/09/2013
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Provider Practice Location Address
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Address Line | 1055 CORPORATE DRIVE
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City | LAWRENCEBURG
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State | KY
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Zip | 40342
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Country | US
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Telephone | 502-839-5590
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Fax | 502-839-3450
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Provider Business Mailing Address
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Address Line | 1055 WELLINGTON WAY SUITE 275
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City | LEXINGTON
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State | KY
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Zip | 40513-1259
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Country | US
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Telephone | 859-219-2828
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Fax | 859-219-0524
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Authorized Official
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Title or Position | OWNER
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Name | ANN S GILES
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Credential |
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Telephone | 859-219-2828
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State | KY
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 700156
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License Number State | KY
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