# APPALACHIAN PRIMARY CARE LLC

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

## Provider details

- **NPI number:** 1265971782
- **Authorized official:** MOHAMMED MAZUMDER M.D. (PRESIDENT)
- **Authorized official phone:** (646) 707-7415

## Contact information

- **Practice address:** 92 PICKETT LN, PRESTONSBURG, KY 41653-8569
- **Practice address phone:** (606) 874-0112
- **Practice address fax:** (606) 874-0115
- **Mailing address:** 92 PICKETT LN, PRESTONSBURG, KY 41653-8569
- **Mailing address phone:** (606) 874-0112
- **Mailing address fax:** (606) 874-0115

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 43704 | KY | Yes |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207QA0401X | Addiction Medicine (Family Medicine) Physician | 43704 | KY | — |

## Other

- **Enumeration date:** 02/16/2017
- **Last updated:** 03/19/2019