# BLUEGRASS DIRECT PRIMARY CARE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Bluegrass Direct Primary Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1700582327
- **Authorized official:** DR. COLTON JAYNE MD (PHYSICIAN/ OWNER)
- **Authorized official phone:** (859) 710-6300

## Contact information

- **Practice address:** 227 E MAIN ST, GEORGETOWN, KY 40324-1711
- **Practice address phone:** (606) 424-3068
- **Mailing address:** 227 E MAIN ST, GEORGETOWN, KY 40324-1711
- **Mailing address phone:** (606) 424-3068
- **Mailing address fax:** (843) 288-4139

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |

## Other

- **Enumeration date:** 02/06/2023
- **Last updated:** 09/13/2023