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Organization
MD GROUP PSC
Active
Organization
MD GROUP PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY L BARRESI DO (OWNER)
(502) 593-0083
Entity
Organization
Contact information
Practice address
1006 NEW MOODY LN, LA GRANGE, KY 40031-9122
(502) 593-0083
(888) 310-2675
Mailing address
1006 NEW MOODY LN, LA GRANGE, KY 40031-9122
(502) 593-0083
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
KY
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
01/06/2016
Last updated
01/06/2016
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