| Mountain Family Medicine, Llc | |
|
5425 N Mayo Trl Ste 201 Pikeville KY 41501-2965 | |
| (606) 432-0191 | |
| Not Available |
| Full Name | Mountain Family Medicine, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 5425 N Mayo Trl Ste 201, Pikeville, Kentucky |
| Authorized Official Name and Position | Brian Daniels (OWNER/PHYSICIAN) |
| Authorized Official Contact | 6064320191 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountain Family Medicine, Llc 5425 N Mayo Trl Ste 201 Pikeville KY 41501-2965 Ph: (606) 432-0191 | Mountain Family Medicine, Llc 5425 N Mayo Trl Ste 201 Pikeville KY 41501-2965 Ph: (606) 432-0191 |
| NPI Number | 1073079273 |
|---|---|
| Provider Enumeration Date | 02/13/2019 |
| Last Update Date | 10/11/2021 |
| Medicare PECOS PAC ID | 2860728425 |
|---|---|
| Medicare Enrollment ID | O20190719002505 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073079273 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 363A00000X | Physician Assistant | (* (Not Available)) | Secondary |
| Provider Name | Brian P Daniels |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437441953 PECOS PAC ID: 4981822160 Enrollment ID: I20140829001720 |
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