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Organization
EAST KY HEALTH SERVICE CENTER
Active
Organization
EAST KY HEALTH SERVICE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BENNY RAY BAILEY PH.D. (EXECUTIVE DIRECTOR)
(606) 785-3164
Entity
Organization
Contact information
Practice address
566 HIGHWAY 899, HINDMAN, KY 41822-0849
(606) 785-3164
(606) 785-0107
Mailing address
PO BOX 849, 566 HWY 899, HINDMAN, KY 41822-0849
(606) 785-3164
(606) 785-0107
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
6629
KY
261QP2300X
Primary Care Clinic/Center
700002
KY
363LP2300X
Primary Care Nurse Practitioner
Primary
3008325
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65924300
—
KY
Enumeration date
09/14/2006
Last updated
06/10/2021
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