Provider Demographics
NPI:1861576365
Name:SE KENTUCKY FAMILY PRACTICE CLINICS INC
Entity type:Organization
Organization Name:SE KENTUCKY FAMILY PRACTICE CLINICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PRISCILLA
Authorized Official - Middle Name:
Authorized Official - Last Name:PARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-528-0283
Mailing Address - Street 1:PO BOX 1125
Mailing Address - Street 2:
Mailing Address - City:CORBIN
Mailing Address - State:KY
Mailing Address - Zip Code:40702-1125
Mailing Address - Country:US
Mailing Address - Phone:606-528-0283
Mailing Address - Fax:606-528-8422
Practice Address - Street 1:206 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CORBIN
Practice Address - State:KY
Practice Address - Zip Code:40701-1456
Practice Address - Country:US
Practice Address - Phone:606-528-0283
Practice Address - Fax:606-528-8422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty