| Eastern Kentucky Family Medicine Pllc | |
|
713 Broadway St Paintsville KY 41240-1465 | |
| (606) 789-4255 | |
| (606) 886-9908 |
| Full Name | Eastern Kentucky Family Medicine Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 713 Broadway St, Paintsville, Kentucky |
| Authorized Official Name and Position | Jason Castle (SOLE MEMBER) |
| Authorized Official Contact | 6067894255 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eastern Kentucky Family Medicine Pllc P.o. Box 1810 Prestonsburg KENTUCKY 41653 Ph: (606) 886-0224 | Eastern Kentucky Family Medicine Pllc 713 Broadway St Paintsville KY 41240-1465 Ph: (606) 789-4255 |
| NPI Number | 1730337247 |
|---|---|
| Provider Enumeration Date | 09/09/2008 |
| Last Update Date | 05/04/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730337247 | NPI | - | NPPES |
| 7100056750 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 42069 (Kentucky) | Primary |
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