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Organization
KENTUCKY CENTER FOR THE PREVENTION OF HEART ATTACK STOKE AND DIABETES
Active
Organization
KENTUCKY CENTER FOR THE PREVENTION OF HEART ATTACK STOKE AND DIABETES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILLIP BALE (OWNER AND PHYSICIAN)
(270) 670-8777
Entity
Organization
Contact information
Practice address
1214 N RACE ST, SUITE B, GLASGOW, KY 42141-3462
(270) 670-8777
Mailing address
1214 N RACE ST, SUITE B, GLASGOW, KY 42141-3462
(270) 670-8777
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
07/31/2007
Last updated
04/17/2009
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