| J & J Diagnostics | |
|
255 Church St Ste 1-a Pikeville KY 41501-3476 | |
| (606) 637-2273 | |
| (606) 637-7849 |
| Full Name | J & J Diagnostics |
|---|---|
| Speciality | Family Medicine |
| Location | 255 Church St Ste 1-a, Pikeville, Kentucky |
| Authorized Official Name and Position | Janelle White (CEO) |
| Authorized Official Contact | 6066377848 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| J & J Diagnostics 102 Branham Hl Betsy Layne KY 41605-7068 Ph: (606) 422-9330 | J & J Diagnostics 255 Church St Ste 1-a Pikeville KY 41501-3476 Ph: (606) 637-2273 |
| NPI Number | 1417502733 |
|---|---|
| Provider Enumeration Date | 08/04/2019 |
| Last Update Date | 05/04/2024 |
| Certification Date | 05/04/2024 |
| Medicare PECOS PAC ID | 8628478799 |
|---|---|
| Medicare Enrollment ID | O20210610001664 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417502733 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| 363A00000X | Physician Assistant | () | Secondary |
| 363L00000X | Nurse Practitioner | () | Secondary |
| 363LF0000X | Nurse Practitioner - Family | () | Secondary |
| Provider Name | James Robert Hager |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386617322 PECOS PAC ID: 8224066113 Enrollment ID: I20050802000052 |
| Provider Name | Shirley a Goff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386834273 PECOS PAC ID: 7416041876 Enrollment ID: I20070917000520 |
| Provider Name | Bethany S Sullivan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962740969 PECOS PAC ID: 3476708363 Enrollment ID: I20130226000219 |
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