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NPI Code Detail

MEDICARE: BARBOURVILLE FAMILY HEALTH CENTER

MEDICARE: BARBOURVILLE FAMILY HEALTH CENTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician
2261QR1300XRural Health Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1073599056
Entity Type Code : Organization
Provider Name (Legal Business Name) : BARBOURVILLE FAMILY HEALTH CENTER
Provider Business Mailing Address
First Line : PO BOX 1150
Second Line :
City : BARBOURVILLE
State : KY
Zip : 40906-5150
Country : US
Telephone Number : 606-546-9287
Fax Number : 606-546-9363
Provider Business Practice Location Address
First Line : 140 BRYAN BLVD
Second Line :
City : CORBIN
State : KY
Zip : 40701-2775
Country : US
Telephone Number : 606-523-2005
Fax Number : 606-546-9363
Authorized Official
Title or Position : PRACTICE MANAGER
Name : STEPHANIE J WILSON
Credential :
Telephone Number : 606-546-9287
Provider Enumeration Date : 12/21/2005
Last Update Date : 01/08/2014

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Directions to “BARBOURVILLE FAMILY HEALTH CENTER ” Practice Location

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