| Smithland Medical Clinic | |
|
205 E Adair St Smithland KY 42081-9507 | |
| (270) 928-2146 | |
| (270) 928-4492 |
| Full Name | Smithland Medical Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 205 E Adair St, Smithland, Kentucky |
| Authorized Official Name and Position | Michael Albin Heneisen (AGENT) |
| Authorized Official Contact | 2709883298 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Smithland Medical Clinic 141 Hospital Drive Po Box 347 Salem KY 42078-0347 Ph: (270) 988-3298 | Smithland Medical Clinic 205 E Adair St Smithland KY 42081-9507 Ph: (270) 928-2146 |
| NPI Number | 1598885998 |
|---|---|
| Provider Enumeration Date | 03/30/2007 |
| Last Update Date | 01/06/2015 |
| Medicare PECOS PAC ID | 8426965278 |
|---|---|
| Medicare Enrollment ID | O20040511001797 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598885998 | NPI | - | NPPES |
| 7890094100 | Medicaid | KY | |
| 7100091610 | Medicaid | KY | |
| 6590103500 | Medicaid | KY |
| Provider Name | Michael P Gavin |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1669442620 PECOS PAC ID: 1557384799 Enrollment ID: I20060113000160 |
| Provider Name | Robert M Wilkinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457378044 PECOS PAC ID: 1850488065 Enrollment ID: I20071106000093 |
| Provider Name | Ghassan Yazigi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538127378 PECOS PAC ID: 8224105002 Enrollment ID: I20100420000565 |
| Provider Name | William Barnes |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1215985148 PECOS PAC ID: 3476643057 Enrollment ID: I20100513000387 |
| Provider Name | Lee A. Keller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700191228 PECOS PAC ID: 0648488015 Enrollment ID: I20110331000358 |
| Provider Name | Demetrius Patton |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1730184730 PECOS PAC ID: 5991794331 Enrollment ID: I20130129000508 |
| Provider Name | Kara Ann Phillips |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649649716 PECOS PAC ID: 8426367814 Enrollment ID: I20151026002801 |
| Provider Name | Jessica Y Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598273690 PECOS PAC ID: 4981964202 Enrollment ID: I20180207000402 |
| Provider Name | Christine Huckabee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336688001 PECOS PAC ID: 8527483775 Enrollment ID: I20200804003457 |
| Provider Name | Danielle N Guminski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932851219 PECOS PAC ID: 4981098597 Enrollment ID: I20220224002336 |
| Provider Name | Robin D Leidecker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134877038 PECOS PAC ID: 2163819384 Enrollment ID: I20220418001779 |
Arcare Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 750 Us Highway 60 W, Smithland, KY 42081 Phone: 270-928-2065 | |
Smithland Medical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 205 E Adair Street, Smithland, KY 42081 Phone: 270-928-2146 Fax: 270-928-4492 | |
Arcare Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 850 Cutoff Rd, Smithland, KY 42081 Phone: 270-928-3500 |