| Advanced Internal Medicine PLLC | |
|
2005 Broadway St Paducah KY 42001-7107 | |
| (270) 366-7650 | |
| (270) 443-0660 |
| Full Name | Advanced Internal Medicine PLLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 2005 Broadway St, Paducah, Kentucky |
| Authorized Official Name and Position | Ryan Curtis Frazine (SOLE MEMBER) |
| Authorized Official Contact | 2709942625 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Internal Medicine PLLC 2005 Broadway St Paducah KY 42001-7107 Ph: (270) 366-7650 | Advanced Internal Medicine PLLC 2005 Broadway St Paducah KY 42001-7107 Ph: (270) 366-7650 |
| NPI Number | 1336563543 |
|---|---|
| Provider Enumeration Date | 02/07/2014 |
| Last Update Date | 12/29/2022 |
| Certification Date | 12/29/2022 |
| Medicare PECOS PAC ID | 9537392154 |
|---|---|
| Medicare Enrollment ID | O20140507000318 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336563543 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| 363LF0000X | Nurse Practitioner - Family | () | Secondary |
| Provider Name | Deborah a French |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1952373854 PECOS PAC ID: 6305831827 Enrollment ID: I20040415000603 |
| Provider Name | Ryan C Frazine |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548339070 PECOS PAC ID: 8426005240 Enrollment ID: I20050405000120 |
| Provider Name | Carla D Frazine |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1417153982 PECOS PAC ID: 9335208297 Enrollment ID: I20081106000452 |
| Provider Name | Jennifer S Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821311143 PECOS PAC ID: 6800924515 Enrollment ID: I20130305000638 |
| Provider Name | Isaac R Mittendorf |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528595352 PECOS PAC ID: 5597020941 Enrollment ID: I20200618003015 |
| Provider Name | Dalton T Henderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841914439 PECOS PAC ID: 8325415128 Enrollment ID: I20221108002104 |
Jeffrey L. Riney M.D. & Associates PLLC Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 225 Medical Center Dr, Suite 209b, Paducah, KY 42003 Phone: 270-441-4610 Fax: 270-441-4608 |
Emerald Healthcare Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2520 New Holt Rd Ste I, Paducah, KY 42001 Phone: 270-310-9200 Fax: 270-477-0007 |
Kentuckycare 161 Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 125 S 20th St, Paducah, KY 42001 Phone: 270-575-3247 Fax: 270-442-7335 |
Wilson Medical Staffing Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2603 Kentucky Ave Ste 305, Paducah, KY 42003 Phone: 270-558-5456 Fax: 270-558-5471 |
Mercy Health Physicians Kentucky Specialty Care LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 225 Medical Center Dr Ste 202, Paducah, KY 42003 Phone: 270-441-4510 Fax: 270-441-4512 |
Baptist Health Medical Group Strawberry Hills Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2670 Holt Road, Suite 200, Paducah, KY 42001 Phone: 270-575-2875 Fax: 270-575-2877 |