| Mt. Sterling Clinic, Pllc. | |
|
100 Sterling Way Suite 1 Mt. Sterling KY 40353 | |
| (859) 498-0200 | |
| (859) 498-5812 |
| Full Name | Mt. Sterling Clinic, Pllc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 100 Sterling Way, Mt. Sterling, Kentucky |
| Authorized Official Name and Position | Lon Edward Roberts (PRESIDENT) |
| Authorized Official Contact | 8594980200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mt. Sterling Clinic, Pllc. 100 Sterling Way Suite 1 Mt. Sterling KY 40353 Ph: (859) 498-0200 | Mt. Sterling Clinic, Pllc. 100 Sterling Way Suite 1 Mt. Sterling KY 40353 Ph: (859) 498-0200 |
| NPI Number | 1316920663 |
|---|---|
| Provider Enumeration Date | 11/21/2005 |
| Last Update Date | 05/18/2010 |
| Medicare PECOS PAC ID | 3476527995 |
|---|---|
| Medicare Enrollment ID | O20040820001088 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316920663 | NPI | - | NPPES |
| 65937849 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Shelly Marie Rogers |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497795116 PECOS PAC ID: 6305875444 Enrollment ID: I20050809000290 |
| Provider Name | Julia K Maness |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154427904 PECOS PAC ID: 9537187505 Enrollment ID: I20051108000696 |
| Provider Name | Dan E Calleja |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871532366 PECOS PAC ID: 3274628557 Enrollment ID: I20071002000104 |
| Provider Name | Brigitte D King |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780666305 PECOS PAC ID: 7012197536 Enrollment ID: I20110215000791 |
| Provider Name | Jennifer Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154844678 PECOS PAC ID: 7618249335 Enrollment ID: I20170815004271 |