| Lincoln Trail Medical Assoc., Pllc | |
|
700 W Lincoln Trail Blvd Radcliff KY 40160-2604 | |
| (270) 351-3192 | |
| (270) 351-5499 |
| Full Name | Lincoln Trail Medical Assoc., Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 700 W Lincoln Trail Blvd, Radcliff, Kentucky |
| Authorized Official Name and Position | Jawed M Movania (OWNER) |
| Authorized Official Contact | 2703513192 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lincoln Trail Medical Assoc., Pllc 700 W Lincoln Trail Blvd Radcliff KY 40160-2604 Ph: (270) 351-3192 | Lincoln Trail Medical Assoc., Pllc 700 W Lincoln Trail Blvd Radcliff KY 40160-2604 Ph: (270) 351-3192 |
| NPI Number | 1750356986 |
|---|---|
| Provider Enumeration Date | 02/21/2006 |
| Last Update Date | 06/22/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750356986 | NPI | - | NPPES |
| 000000047366 | Other | KY | ANTHEM ID # |
| 64315781 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 31578 (Kentucky) | Primary |
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