| Kenneth W Cloern, MD | |
|
215 E Main St, Providence, KY 42450-1261 | |
| (270) 667-7017 | |
| (270) 667-9065 |
| Full Name | Kenneth W Cloern |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 215 E Main St, Providence, Kentucky |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275587008 | NPI | - | NPPES |
| 6429655100 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 29655 (Kentucky) | Primary |
| Entity Name | Regional Health Care Affiliates, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1558692558 PECOS PAC ID: 3173668274 Enrollment ID: O20100824000119 |
| Mailing Address | Practice Location Address |
|---|---|
| Kenneth W Cloern, MD Po Box 37, Providence, KY 42450-0037 Ph: (270) 667-7017 | Kenneth W Cloern, MD 215 E Main St, Providence, KY 42450-1261 Ph: (270) 667-7017 |
Tristan K Lineberry, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 215 E Main St, Providence, KY 42450 Phone: 270-667-7017 | |
Kelly L Cole, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 121 E Main St, Providence, KY 42450 Phone: 270-667-2023 Fax: 270-667-7518 | |
Jami T Perry, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 215 E Main St, Providence, KY 42450 Phone: 270-667-7017 Fax: 270-667-9065 |