| South Kentucky Physician Services, Inc. | |
|
202-206 Milby Street Greensburg KY 42743 | |
| (270) 634-1921 | |
| Not Available |
| Full Name | South Kentucky Physician Services, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 202-206 Milby Street, Greensburg, Kentucky |
| Authorized Official Name and Position | Gary Ledford Partin (CHIEF MEDICAL OFFICER) |
| Authorized Official Contact | 2706341921 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| South Kentucky Physician Services, Inc. 1597 Bliss Rd Columbia KY 42728-8510 Ph: (270) 634-1921 | South Kentucky Physician Services, Inc. 202-206 Milby Street Greensburg KY 42743 Ph: (270) 634-1921 |
| NPI Number | 1629346945 |
|---|---|
| Provider Enumeration Date | 12/01/2011 |
| Last Update Date | 04/07/2017 |
| Medicare PECOS PAC ID | 5395905459 |
|---|---|
| Medicare Enrollment ID | O20120327000671 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629346945 | NPI | - | NPPES |
| 64252638 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 25262 (Kentucky) | Primary |
| Provider Name | Gary Partin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386614188 PECOS PAC ID: 8820124639 Enrollment ID: I20100331000873 |
| Provider Name | Adil M Mohiuddin |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1073065983 PECOS PAC ID: 7012273139 Enrollment ID: I20171106002778 |
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