# CORBIN LONDON MEDICAL ASSOCIATES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689848525
- **Authorized official:** DR. JONATHAN E. MOORE M.D. (PRESIDENT/OWNER)
- **Authorized official phone:** (606) 528-0305

## Contact information

- **Practice address:** 1007 CUMBERLAND FALLS HWY, CORBIN, KY 40701
- **Practice address phone:** (606) 528-0305
- **Practice address fax:** (606) 523-4368
- **Mailing address:** 1007 CUMBERLAND FALLS HWY, CORBIN, KY 40701
- **Mailing address phone:** (606) 528-0305
- **Mailing address fax:** (606) 523-4368

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 1033143 | KY | Yes |
| 207Q00000X | Family Medicine Physician | 1086037 | KY | — |
| 207R00000X | Internal Medicine Physician | 39404 | KY | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | 002008 | KY | — |

## Other

- **Enumeration date:** 04/22/2008
- **Last updated:** 07/28/2011