| Kentucky Mso Llc | |
|
3501 Main St Stamping Ground KY 40379-9631 | |
| (502) 535-5686 | |
| (502) 535-5585 |
| Full Name | Kentucky Mso Llc |
|---|---|
| Speciality | Nurse Practitioner - Family |
| Location | 3501 Main St, Stamping Ground, Kentucky |
| Authorized Official Name and Position | Jess N Judy (PRESIDENT) |
| Authorized Official Contact | 6153728500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kentucky Mso Llc 3501 Main St Stamping Ground KY 40379-9631 Ph: (502) 535-5686 | Kentucky Mso Llc 3501 Main St Stamping Ground KY 40379-9631 Ph: (502) 535-5686 |
| NPI Number | 1417224585 |
|---|---|
| Provider Enumeration Date | 11/17/2011 |
| Last Update Date | 12/19/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417224585 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Primary |
Stamping Ground Family Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3501 Main Street, Stamping Ground, KY 40379 Phone: 502-535-5686 |