| Kentucky River Physician Corporation | |
|
726 Highway 15 N Suite 4 Jackson KY 41339-8601 | |
| (606) 666-2545 | |
| (606) 666-2621 |
| Full Name | Kentucky River Physician Corporation |
|---|---|
| Speciality | Clinic/Center |
| Location | 726 Highway 15 N, Jackson, Kentucky |
| Authorized Official Name and Position | Laura J Fey (SR. DIRECTOR PHYSICIAN REV CYCLE) |
| Authorized Official Contact | 6152213641 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kentucky River Physician Corporation 1573 Mallory Ln Ste 100 Brentwood TN 37027-2895 Ph: (152) 221-1400 | Kentucky River Physician Corporation 726 Highway 15 N Suite 4 Jackson KY 41339-8601 Ph: (606) 666-2545 |
| NPI Number | 1831411354 |
|---|---|
| Provider Enumeration Date | 02/25/2010 |
| Last Update Date | 07/07/2023 |
| Medicare PECOS PAC ID | 1355434309 |
|---|---|
| Medicare Enrollment ID | O20070906000585 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831411354 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 700199 (Kentucky) | Primary |
| Provider Name | George E Burnette |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003815390 PECOS PAC ID: 3173692241 Enrollment ID: I20080514000874 |
| Provider Name | Kathryn A Morgan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295283448 PECOS PAC ID: 8921387978 Enrollment ID: I20161114002471 |
| Provider Name | Rebecca Holbrook-watkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083145866 PECOS PAC ID: 6204113483 Enrollment ID: I20170426002317 |
| Provider Name | Deanna Lane Wright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114439825 PECOS PAC ID: 1951668110 Enrollment ID: I20171127002323 |
| Provider Name | Brittney Denise Herald |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053960534 PECOS PAC ID: 8729411327 Enrollment ID: I20191212002810 |
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