# WILLIAMSBURG FAMILY PRACTICE CLINIC, INC.

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

## Provider details

- **NPI number:** 1295738524
- **Authorized official:** ROBERT A. CARTER JR. (PRESIDENT)
- **Authorized official phone:** (606) 528-0283

## Contact information

- **Practice address:** 965 S HIGHWAY 25 W, STE 52, WILLIAMSBURG, KY 40769-1608
- **Practice address phone:** (606) 549-2588
- **Practice address fax:** (606) 549-1945
- **Mailing address:** PO BOX 1125, CORBIN, KY 40702-1125
- **Mailing address phone:** (606) 528-0283
- **Mailing address fax:** (606) 528-8422

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | 4464P | KY | Yes |

## Other

- **Enumeration date:** 05/31/2005
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 35001098 | — | KY |