MEDICARE: FAMILY MEDICAL SPECIALTY CLINIC D.B.A.

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	207R00000X	Internal Medicine Physician

Other Identifiers

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

General Provider Information

NPI Number	:	1497817944
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY MEDICAL SPECIALTY CLINIC D.B.A.

Provider Business Mailing Address
First Line	:	4 JACKSON HTS
Second Line	:
City	:	JACKSON
State	:	KY
Zip	:	41339-6500
Country	:	US
Telephone Number	:	606-666-7040
Fax Number	:	606-666-7088

Provider Business Practice Location Address
First Line	:	95 JACKSON HTS
Second Line	:
City	:	JACKSON
State	:	KY
Zip	:	41339-6500
Country	:	US
Telephone Number	:	606-693-0199
Fax Number	:	606-693-0299

Authorized Official
Title or Position	:	PARTNER
Name	:	JUNE ABADILLA
Credential	:	M.D.
Telephone Number	:	606-666-7040

Provider Enumeration Date	:	12/14/2006
Last Update Date	:	04/15/2008

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Directions to “FAMILY MEDICAL SPECIALTY CLINIC D.B.A. ” Practice Location

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