Provider Demographics
NPI:1902146277
Name:EPHRAIM MCDOWELL HEALTH RESOURCE, INC
Entity Type:Organization
Organization Name:EPHRAIM MCDOWELL HEALTH RESOURCE, INC
Other - Org Name:EPHRAIM MCDOWELL MULTI SPECIALTY CLINIC WATTS BUILDING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:M
Authorized Official - Last Name:SNAPP
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:859-239-2424
Mailing Address - Street 1:PO BOX 990
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40423-0990
Mailing Address - Country:US
Mailing Address - Phone:859-239-2312
Mailing Address - Fax:859-239-6785
Practice Address - Street 1:470 LINDEN AVE STE 7
Practice Address - Street 2:
Practice Address - City:HARRODSBURG
Practice Address - State:KY
Practice Address - Zip Code:40330
Practice Address - Country:US
Practice Address - Phone:859-733-5859
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EPHRAIM MCDOWELL HEALTH RESOURCE, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-02-25
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty