# FAMILY & INTERNAL MEDICINE ASSOCIATES PLLC

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

## Provider details

- **NPI number:** 1780682609
- **Authorized official:** JIM OSBOURNE (OFFICE ADMINISTRATOR)
- **Authorized official phone:** (270) 699-9500

## Contact information

- **Practice address:** 325 W WALNUT ST, STE 600, LEBANON, KY 40033-1378
- **Practice address phone:** (270) 699-9500
- **Practice address fax:** (270) 699-9550
- **Mailing address:** 325 W WALNUT ST, STE 600, LEBANON, KY 40033-1378
- **Mailing address phone:** (270) 699-9500
- **Mailing address fax:** (270) 699-9550

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |

## Other

- **Enumeration date:** 07/13/2005
- **Last updated:** 10/02/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1077750 | PASSPORT | KY |
| 01 | — | 18D0320437 | CLIA | KY |
| 01 | — | 2435329002 | PASSPORT ADVANTAGE | KY |
| 05 | — | 35002005 | — | KY |
| 05 | — | 65932105 | — | KY |