# FAMILY CARE CLINIC PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Family Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679053581
- **Authorized official:** JERYL L PITTMAN APRN (MEMBER/OWNER)
- **Authorized official phone:** (859) 893-3588

## Contact information

- **Practice address:** 3190 IRVINE RD, RICHMOND, KY 40475-9031
- **Practice address phone:** (859) 369-0070
- **Mailing address:** 3190 IRVINE RD, RICHMOND, KY 40475-9031
- **Mailing address phone:** (859) 369-0070
- **Mailing address fax:** (859) 369-0073

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 261QP2300X | Primary Care Clinic/Center | — | NULL | — |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 08/20/2018
- **Last updated:** 12/29/2020