| Villagemd Kentucky, Psc | |
|
1000 S 12th St Murray KY 42071 | |
| (270) 759-9200 | |
| (270) 759-8368 |
| Full Name | Villagemd Kentucky, Psc |
|---|---|
| Speciality | Family Medicine |
| Location | 1000 S 12th St, Murray, Kentucky |
| Authorized Official Name and Position | Wendy Lee Rubas (GENERAL COUNSEL) |
| Authorized Official Contact | 3124657898 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Villagemd Kentucky, Psc 125 S Clark St Ste 900 Chicago IL 60603-5200 Ph: (312) 465-7900 | Villagemd Kentucky, Psc 1000 S 12th St Murray KY 42071 Ph: (270) 759-9200 |
| NPI Number | 1104348622 |
|---|---|
| Provider Enumeration Date | 07/17/2017 |
| Last Update Date | 05/17/2018 |
| Medicare PECOS PAC ID | 3375819998 |
|---|---|
| Medicare Enrollment ID | O20171026003047 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104348622 | NPI | - | NPPES |
| Provider Name | Clive K Fields |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366447583 PECOS PAC ID: 2961436845 Enrollment ID: I20171101003201 |
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