| Yahweh Medical Clinic Barbourville | |
|
14 Knox Plz Barbourville KY 40906-7300 | |
| (606) 545-2908 | |
| (606) 401-0061 |
| Full Name | Yahweh Medical Clinic Barbourville |
|---|---|
| Speciality | Clinic/Center |
| Location | 14 Knox Plz, Barbourville, Kentucky |
| Authorized Official Name and Position | Michelle Broughton (OWNER) |
| Authorized Official Contact | 6066275564 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Yahweh Medical Clinic Barbourville 14 Knox Plz Barbourville KY 40906-7300 Ph: (606) 545-2908 | Yahweh Medical Clinic Barbourville 14 Knox Plz Barbourville KY 40906-7300 Ph: (606) 545-2908 |
| NPI Number | 1447820584 |
|---|---|
| Provider Enumeration Date | 06/30/2021 |
| Last Update Date | 05/05/2022 |
| Medicare PECOS PAC ID | 0547666992 |
|---|---|
| Medicare Enrollment ID | O20210909002304 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447820584 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | Michelle L Broughton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053540674 PECOS PAC ID: 5799831343 Enrollment ID: I20090923000175 |
| Provider Name | Maryann Perry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336609114 PECOS PAC ID: 0749606085 Enrollment ID: I20200817002761 |
| Provider Name | Glenna M Bargo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891116455 PECOS PAC ID: 3779713847 Enrollment ID: I20220620001116 |
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