MEDICARE: HEBRON MEDICAL CENTER LLC

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
1	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1477287472
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEBRON MEDICAL CENTER LLC

Provider Business Mailing Address
First Line	:	2091 N BEND RD
Second Line	:
City	:	HEBRON
State	:	KY
Zip	:	41048-9691
Country	:	US
Telephone Number	:	859-271-4730
Fax Number	:

Provider Business Practice Location Address
First Line	:	2091 N BEND RD
Second Line	:
City	:	HEBRON
State	:	KY
Zip	:	41048-9691
Country	:	US
Telephone Number	:	859-271-4730
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DAVID SEGRAVES
Credential	:
Telephone Number	:	513-486-3744

Provider Enumeration Date	:	07/14/2022
Last Update Date	:	07/14/2022

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Directions to “HEBRON MEDICAL CENTER LLC ” Practice Location

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