| East Ky Pulmonary & Sleep Disorder Ctr. | |
|
9350 Us Hwy 23 South Suite 104 Stanville KY 41659 | |
| (606) 478-1005 | |
| (606) 478-8687 |
| Full Name | East Ky Pulmonary & Sleep Disorder Ctr. |
|---|---|
| Speciality | Internal Medicine |
| Location | 9350 Us Hwy 23 South, Stanville, Kentucky |
| Authorized Official Name and Position | Srinivas Ammisetty (PRESIDENT) |
| Authorized Official Contact | 6064781005 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| East Ky Pulmonary & Sleep Disorder Ctr. Po Box 70 Stanville KY 41659-0070 Ph: (606) 478-1005 | East Ky Pulmonary & Sleep Disorder Ctr. 9350 Us Hwy 23 South Suite 104 Stanville KY 41659 Ph: (606) 478-1005 |
| NPI Number | 1013063106 |
|---|---|
| Provider Enumeration Date | 01/25/2007 |
| Last Update Date | 06/25/2008 |
| Medicare PECOS PAC ID | 3779512447 |
|---|---|
| Medicare Enrollment ID | O20050812000078 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013063106 | NPI | - | NPPES |
| Provider Name | Srinivas M Ammisetty |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1689758799 PECOS PAC ID: 6305742487 Enrollment ID: I20031210000003 |
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