| Prospect Health And Community Llc | |
|
1035 Wall St Ste 206 Jeffersonville IN 47130-3694 | |
| (859) 443-6697 | |
| Not Available |
| Full Name | Prospect Health And Community Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1035 Wall St Ste 206, Jeffersonville, Indiana |
| Authorized Official Name and Position | Anas Alzuhaili (OWNER) |
| Authorized Official Contact | 8594436697 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prospect Health And Community Llc 5804 Tee View Ct Prospect KY 40059-8555 Ph: () - | Prospect Health And Community Llc 1035 Wall St Ste 206 Jeffersonville IN 47130-3694 Ph: (859) 443-6697 |
| NPI Number | 1689404741 |
|---|---|
| Provider Enumeration Date | 08/05/2024 |
| Last Update Date | 08/05/2024 |
| Medicare PECOS PAC ID | 7517498199 |
|---|---|
| Medicare Enrollment ID | O20241007003182 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689404741 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Denise B Wilburn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417984758 PECOS PAC ID: 0941205439 Enrollment ID: I20140814000105 |
| Provider Name | Anas Alzuhaili |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417188491 PECOS PAC ID: 1759535792 Enrollment ID: I20180115000281 |
| Provider Name | Amanda Wiley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326542820 PECOS PAC ID: 6800158999 Enrollment ID: I20210805003532 |
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