| Stonecrest Family Medicine Pllc | |
|
101 Stonecrest Road Suite 3 Shelbyville KY 40065 | |
| (502) 633-5565 | |
| (502) 633-5154 |
| Full Name | Stonecrest Family Medicine Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 101 Stonecrest Road, Shelbyville, Kentucky |
| Authorized Official Name and Position | Ronald E Creque (OWNER) |
| Authorized Official Contact | 5026335565 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stonecrest Family Medicine Pllc 101 Stonecrest Road Suite 3 Shelbyville KY 40065 Ph: (502) 633-5565 | Stonecrest Family Medicine Pllc 101 Stonecrest Road Suite 3 Shelbyville KY 40065 Ph: (502) 633-5565 |
| NPI Number | 1659322808 |
|---|---|
| Provider Enumeration Date | 05/12/2006 |
| Last Update Date | 08/20/2014 |
| Medicare PECOS PAC ID | 4284631193 |
|---|---|
| Medicare Enrollment ID | O20061106000478 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659322808 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 36516 (Kentucky) | Primary |
| Provider Name | Ron Creque |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194717397 PECOS PAC ID: 5092712901 Enrollment ID: I20061106000495 |
| Provider Name | Paul A Goodlett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770575979 PECOS PAC ID: 2163429085 Enrollment ID: I20061106000517 |
| Provider Name | Jinjerita C Lucas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659694081 PECOS PAC ID: 6305097668 Enrollment ID: I20130627000854 |
Family Physician Associates Psc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 515 Hospital Dr, Suite 1, Shelbyville, KY 40065 Phone: 502-633-3525 Fax: 502-633-3825 | |
Shelby One Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 30 Main St, Shelbyville, KY 40065 Phone: 502-229-1744 | |
Cumberland Family Medical Center Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 615 11th St, Shelbyville, KY 40065 Phone: 270-692-2774 Fax: 270-692-3559 | |
Baptist Health Medical Group Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 101 Stonecrest Rd, Shelbyville, KY 40065 Phone: 502-633-2233 Fax: 502-633-3833 | |
Operation Care Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 615 Washington St, Shelbyville, KY 40065 Phone: 502-647-4668 Fax: 502-647-4668 | |
Surgical Associates Psc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 30 Stonecrest Ct, Suite 104, Shelbyville, KY 40065 Phone: 502-633-6062 Fax: 502-633-6810 | |
Pulmonary Care Service Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 720 Hospital Dr, Ste 106, Shelbyville, KY 40065 Phone: 502-633-1151 |