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Organization
FAMILY MEDICAL CARE OF MANCHESTER
Active
Organization
FAMILY MEDICAL CARE OF MANCHESTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOUGLAS GERARDY IRWIN M.D. (OWNER)
(606) 599-9955
Entity
Organization
Contact information
Practice address
94 MARIE LANGDON DR, SUITE 1, MANCHESTER, KY 40962-6353
(606) 599-9955
(606) 599-9966
Mailing address
94 MARIE LANGDON DR, SUITE 1, MANCHESTER, KY 40962-6353
(606) 599-9955
(606) 599-9966
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
38637
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000195439
BLUE CROSS/BLUE SHIELD
KY
01
—
020252900
BLACK LUNG GROUP #
KY
01
—
1168920
PASSPORT GROUP PROVIDER #
KY
05
—
31000813
—
KY
01
—
C92418
CUMBERLAND HEALTHCARE
KY
Enumeration date
06/10/2006
Last updated
07/02/2008
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