# EPHRAIM MCDOWELL HEALTH RESOURCE, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Fort Logan Walk-in & Primary Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386799757
- **Authorized official:** AMANDA KINMAN (CFO)
- **Authorized official phone:** (859) 239-2424

## Contact information

- **Practice address:** 110 METKER TRL, STANFORD, KY 40484-1065
- **Practice address phone:** (606) 365-3360
- **Mailing address:** PO BOX 990, DANVILLE, KY 40423-0990
- **Mailing address phone:** (859) 239-2379

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 900145 | KY | Yes |

## Other

- **Enumeration date:** 01/24/2007
- **Last updated:** 12/30/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 35001478 | — | KY |