| Jaynes Family Practice South Llc | |
|
1507 S Main St Corbin KY 40701-1932 | |
| (606) 280-4044 | |
| (833) 222-3797 |
| Full Name | Jaynes Family Practice South Llc |
|---|---|
| Speciality | Nurse Practitioner - Family |
| Location | 1507 S Main St, Corbin, Kentucky |
| Authorized Official Name and Position | Leslie Jaynes (OWNER) |
| Authorized Official Contact | 6063043794 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jaynes Family Practice South Llc 1507 S Main St Corbin KY 40701-1932 Ph: (606) 280-4044 | Jaynes Family Practice South Llc 1507 S Main St Corbin KY 40701-1932 Ph: (606) 280-4044 |
| NPI Number | 1245943356 |
|---|---|
| Provider Enumeration Date | 01/04/2023 |
| Last Update Date | 01/08/2023 |
| Certification Date | 01/08/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245943356 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Primary |
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