| Family Clinic | |
|
3190 Irvine Rd Richmond KY 40475-9031 | |
| (859) 369-0070 | |
| Not Available |
| Full Name | Family Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 3190 Irvine Rd, Richmond, Kentucky |
| Authorized Official Name and Position | Jeryl L Pittman (MEMBER/OWNER) |
| Authorized Official Contact | 8598933588 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Clinic 3190 Irvine Rd Richmond KY 40475-9031 Ph: (859) 369-0070 | Family Clinic 3190 Irvine Rd Richmond KY 40475-9031 Ph: (859) 369-0070 |
| NPI Number | 1679053581 |
|---|---|
| Provider Enumeration Date | 08/20/2018 |
| Last Update Date | 12/29/2020 |
| Medicare PECOS PAC ID | 4385974518 |
|---|---|
| Medicare Enrollment ID | O20191001001475 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679053581 | NPI | - | NPPES |
| Provider Name | George Michael Pittman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033118864 PECOS PAC ID: 1850335209 Enrollment ID: I20050620000592 |
| Provider Name | Jeryl Pittman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891990479 PECOS PAC ID: 5890932602 Enrollment ID: I20130815000913 |
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