# EASTERN KY HEATLHCARE CENTER

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043346562
- **Authorized official:** JACK KENDRICK MD (PHYSICIAN)
- **Authorized official phone:** (606) 478-4287

## Contact information

- **Practice address:** 8535 KY RT 122, MINNIE, KY 41651
- **Practice address phone:** (606) 478-4287
- **Practice address fax:** (606) 478-4288
- **Mailing address:** PO BOX 100, MINNIE, KY 41651-0100
- **Mailing address phone:** (606) 478-4287
- **Mailing address fax:** (606) 478-4288

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 29774 | KY | Yes |

## Other

- **Enumeration date:** 02/26/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 65941668 | — | KY |
| 01 | — | ANTHEM BLUE CROSS | 000000336367 | KY |
| 01 | — | DD7592 | PALMETTO GBA | KY |