| Damon Gatewood Md Pllc | |
|
58 Citation Lane Campbellsburg KY 40011-1426 | |
| (502) 532-7341 | |
| (502) 532-0127 |
| Full Name | Damon Gatewood Md Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 58 Citation Lane, Campbellsburg, Kentucky |
| Authorized Official Name and Position | Damon L Gatewood (OWNER) |
| Authorized Official Contact | 5025327341 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Damon Gatewood Md Pllc 58 Citation Lane Campbellsburg KY 40011-1426 Ph: (502) 532-7341 | Damon Gatewood Md Pllc 58 Citation Lane Campbellsburg KY 40011-1426 Ph: (502) 532-7341 |
| NPI Number | 1962574897 |
|---|---|
| Provider Enumeration Date | 11/15/2006 |
| Last Update Date | 06/05/2014 |
| Medicare PECOS PAC ID | 7719886001 |
|---|---|
| Medicare Enrollment ID | O20040106000380 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962574897 | NPI | - | NPPES |
| 50003253 | Other | KY | PASSPORT HEALTH PLAN |
| 7100282440 | Medicaid | KY | |
| 7100268000 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 37028 (Kentucky) | Primary |
| 363LF0000X | Nurse Practitioner - Family | 3007904 (Kentucky) | Secondary |
| Provider Name | Damon L Gatewood |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912974171 PECOS PAC ID: 6709785090 Enrollment ID: I20091228000068 |
| Provider Name | Lori P Abney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053654509 PECOS PAC ID: 5092941054 Enrollment ID: I20131121000414 |