| East Mountain Health Clinic Llc | |
|
3165 Blacklog Rd Inez KY 41224-9113 | |
| (606) 534-3435 | |
| (606) 534-3436 |
| Full Name | East Mountain Health Clinic Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 3165 Blacklog Rd, Inez, Kentucky |
| Authorized Official Name and Position | Scott Siegel (DO, OWNER) |
| Authorized Official Contact | 6065343435 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| East Mountain Health Clinic Llc Po Box 389 Inez KY 41224-0389 Ph: (606) 534-3435 | East Mountain Health Clinic Llc 3165 Blacklog Rd Inez KY 41224-9113 Ph: (606) 534-3435 |
| NPI Number | 1578102760 |
|---|---|
| Provider Enumeration Date | 01/05/2020 |
| Last Update Date | 08/18/2020 |
| Medicare PECOS PAC ID | 6709216583 |
|---|---|
| Medicare Enrollment ID | O20200417002783 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578102760 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Scott Alan Siegel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629020326 PECOS PAC ID: 6305857442 Enrollment ID: I20200420001593 |
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