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Organization
BLUEGRASS CLINIC LIBERTY, PLLC
Active
Organization
BLUEGRASS CLINIC LIBERTY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES A MILLER M.D. (PROVIDER OWNER)
(606) 365-8338
Entity
Organization
Contact information
Practice address
256 N WALLACE WILKINSON BLVD, LIBERTY, KY 42539-3014
(160) 678-7001
(606) 787-0035
Mailing address
256 N WALLACE WILKINSON BLVD, LIBERTY, KY 42539-3014
(606) 787-0014
(606) 787-0035
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
261QR1300X
Rural Health Clinic/Center
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100032530
—
KY
Enumeration date
06/14/2007
Last updated
10/25/2023
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