| Georgetown Pediatrics, Psc | |
|
1162 Lexington Rd Georgetown KY 40324-9330 | |
| (502) 863-6426 | |
| (502) 868-9724 |
| Full Name | Georgetown Pediatrics, Psc |
|---|---|
| Speciality | Pediatrics |
| Location | 1162 Lexington Rd, Georgetown, Kentucky |
| Authorized Official Name and Position | Horace P. Hambrick (PRESIDENT) |
| Authorized Official Contact | 5028636426 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Georgetown Pediatrics, Psc 1162 Lexington Rd Georgetown KY 40324-9330 Ph: (502) 863-6426 | Georgetown Pediatrics, Psc 1162 Lexington Rd Georgetown KY 40324-9330 Ph: (502) 863-6426 |
| NPI Number | 1598809097 |
|---|---|
| Provider Enumeration Date | 02/16/2007 |
| Last Update Date | 04/12/2023 |
| Certification Date | 04/25/2022 |
| Medicare PECOS PAC ID | 2365793676 |
|---|---|
| Medicare Enrollment ID | O20180926001679 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598809097 | NPI | - | NPPES |
| 7100177200 | Medicaid | KY | |
| 7100552220 | Medicaid | KY |
| Provider Name | David M Hoddy |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1932215027 PECOS PAC ID: 8426354184 Enrollment ID: I20180927001310 |
| Provider Name | Horace P Hambrick |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1497861686 PECOS PAC ID: 3375849029 Enrollment ID: I20190613002514 |
| Provider Name | William Lee Grey |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1316470271 PECOS PAC ID: 5193073096 Enrollment ID: I20200630002996 |
| Provider Name | Jennifer Riebel |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1831200336 PECOS PAC ID: 6901102656 Enrollment ID: I20210409001731 |
| Provider Name | Kristy Menke |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1265543946 PECOS PAC ID: 2163773482 Enrollment ID: I20210409001752 |
| Provider Name | Jennifer S Oliver |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1538270988 PECOS PAC ID: 5698144863 Enrollment ID: I20221209001201 |
| Provider Name | Ann N Quackenbush |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1982715504 PECOS PAC ID: 7517218837 Enrollment ID: I20221215001537 |
| Provider Name | Lacey B Sweigart |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1225270515 PECOS PAC ID: 7719142983 Enrollment ID: I20221221001259 |
| Provider Name | Cynthia K Smallwood |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1730593401 PECOS PAC ID: 6103131735 Enrollment ID: I20221221001457 |
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