Smith's Hometown Family Practice, Llc | |
359 Old Us Highway 421 Manchester KY 40962-7538 | |
(606) 599-8905 | |
(606) 599-0354 |
Full Name | Smith's Hometown Family Practice, Llc |
---|---|
Speciality | Clinic/center |
Location | 359 Old Us Highway 421, Manchester, Kentucky |
Authorized Official Name and Position | Shawana M.l. Smith (OWNER) |
Authorized Official Contact | 6065998905 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Smith's Hometown Family Practice, Llc 359 Old Us Highway 421 Manchester KY 40962-7538 Ph: (606) 599-8905 | Smith's Hometown Family Practice, Llc 359 Old Us Highway 421 Manchester KY 40962-7538 Ph: (606) 599-8905 |
NPI Number | 1275934614 |
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Provider Enumeration Date | 09/04/2014 |
Last Update Date | 09/04/2014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1275934614 | NPI | - | NPPES |
7100100870 | Medicaid | KY | |
11996475 | Other | KY | CAQH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | 3006073 (Kentucky) | Primary |
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› Verified 3 days ago
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