| Chubinidzemd Pllc | |
|
1306 Old Taylor Trl Goshen KY 40026-9727 | |
| (502) 244-5252 | |
| Not Available |
| Full Name | Chubinidzemd Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 1306 Old Taylor Trl, Goshen, Kentucky |
| Authorized Official Name and Position | Omari Chubinidze (OWNER) |
| Authorized Official Contact | 5022445252 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chubinidzemd Pllc 1306 Old Taylor Trl Goshen KY 40026-9727 Ph: () - | Chubinidzemd Pllc 1306 Old Taylor Trl Goshen KY 40026-9727 Ph: (502) 244-5252 |
| NPI Number | 1760739908 |
|---|---|
| Provider Enumeration Date | 08/07/2012 |
| Last Update Date | 09/01/2015 |
| Medicare PECOS PAC ID | 1355599218 |
|---|---|
| Medicare Enrollment ID | O20231006000736 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760739908 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 41262 (Kentucky) | Primary |
| Provider Name | Omari Chubinidze |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669524096 PECOS PAC ID: 5698874535 Enrollment ID: I20070619000231 |
Wound Professional Services Of Kentucky, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 13317 Westbury Way, Goshen, KY 40026 Phone: 502-409-8223 Fax: 502-409-8330 |