| Grace Health Pediatrics | |
|
120 N Commonwealth Ave Ste 123&4 Corbin KY 40701-6472 | |
| (606) 526-8603 | |
| (606) 526-8607 |
| Full Name | Grace Health Pediatrics |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 120 N Commonwealth Ave Ste 123&4, Corbin, Kentucky |
| Authorized Official Name and Position | Chad Stevens (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 6065269005 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grace Health Pediatrics 1019 Cumberland Falls Hwy Ste B201 Corbin KY 40701-2793 Ph: (606) 526-9005 | Grace Health Pediatrics 120 N Commonwealth Ave Ste 123&4 Corbin KY 40701-6472 Ph: (606) 526-8603 |
| NPI Number | 1811533433 |
|---|---|
| Provider Enumeration Date | 11/19/2019 |
| Last Update Date | 06/28/2024 |
| Certification Date | 06/28/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811533433 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | () | Primary |
| 208000000X | Pediatrics | () | Secondary |
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