| Jaynes Family Practice | |
|
1013 Master St Corbin KY 40701-1065 | |
| (606) 304-3794 | |
| (606) 280-4051 |
| Full Name | Jaynes Family Practice |
|---|---|
| Speciality | Clinic/Center |
| Location | 1013 Master St, Corbin, Kentucky |
| Authorized Official Name and Position | Leslie Gayle Phelps (OWNER) |
| Authorized Official Contact | 6062804000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jaynes Family Practice Po Box 2634 Corbin KY 40702-2634 Ph: (606) 280-4000 | Jaynes Family Practice 1013 Master St Corbin KY 40701-1065 Ph: (606) 304-3794 |
| NPI Number | 1184228553 |
|---|---|
| Provider Enumeration Date | 11/25/2020 |
| Last Update Date | 06/24/2022 |
| Certification Date | 06/24/2022 |
| Medicare PECOS PAC ID | 3779992573 |
|---|---|
| Medicare Enrollment ID | O20210507000532 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184228553 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | () | Secondary |
| 261QR1300X | Clinic/center - Rural Health | () | Primary |
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