Provider Demographics
NPI:1730175001
Name:MEDICAL CONSULTANTS OF EASTERN KENTUCKY
Entity type:Organization
Organization Name:MEDICAL CONSULTANTS OF EASTERN KENTUCKY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.O.O.
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:RANDALL
Authorized Official - Last Name:MULLINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-487-0776
Mailing Address - Street 1:PO BOX 1297
Mailing Address - Street 2:
Mailing Address - City:HAZARD
Mailing Address - State:KY
Mailing Address - Zip Code:41702-1297
Mailing Address - Country:US
Mailing Address - Phone:606-487-0776
Mailing Address - Fax:606-487-0777
Practice Address - Street 1:108 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:HAZARD
Practice Address - State:KY
Practice Address - Zip Code:41701-1071
Practice Address - Country:US
Practice Address - Phone:606-487-0776
Practice Address - Fax:606-487-0777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health