| Colleen M Kirsch Hiltz White, LP | |
|
301 Professional Park Dr, Glasgow, KY 42141-3487 | |
| (270) 651-9696 | |
| (270) 651-0385 |
| Full Name | Colleen M Kirsch Hiltz White |
|---|---|
| Gender | Female |
| Speciality | Psychologist |
| Location | 301 Professional Park Dr, Glasgow, Kentucky |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609587070 | NPI | - | NPPES |
| 15813869 | Other | CAQH | |
| 7100869080 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 282081 (Kentucky) | Primary |
| Entity Name | Cumberland Family Medical Center, Inc.. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1306873500 PECOS PAC ID: 6305947789 Enrollment ID: O20120221000433 |
| Mailing Address | Practice Location Address |
|---|---|
| Colleen M Kirsch Hiltz White, LP Po Box 1080, Burkesville, KY 42717-1080 Ph: (270) 858-6655 | Colleen M Kirsch Hiltz White, LP 301 Professional Park Dr, Glasgow, KY 42141-3487 Ph: (270) 651-9696 |
Mr. Casey R Ford, LPA MA Psychologist Medicare: Not Enrolled in Medicare Practice Location: 104 Reynolds Rd, Glasgow, KY 42141 Phone: 270-678-4801 Fax: 270-904-6570 | |
Tiffany Nicole Sanders, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 104 Reynolds Rd, Glasgow, KY 42141 Phone: 270-904-6570 | |
Dr. Ollie Charles Dennis, M. A., ED. D Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1010 Glenview Dr, Suite-c, Glasgow, KY 42141 Phone: 270-651-2816 Fax: 270-651-2816 |