# MOUNTAIN FAMILY MEDICINE LLC

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

## Provider details

- **NPI number:** 1881006054
- **Authorized official:** DR. RAYMOND O BISHOP MD (OWNER)
- **Authorized official phone:** (606) 432-0191

## Contact information

- **Practice address:** 419 TOWN MOUNTAIN RD, SUITE 206, PIKEVILLE, KY 41501-1631
- **Practice address phone:** (606) 432-0191
- **Practice address fax:** (606) 432-0111
- **Mailing address:** 419 TOWN MOUNTAIN RD, SUITE 206, PIKEVILLE, KY 41501-1631
- **Mailing address phone:** (606) 432-0191
- **Mailing address fax:** (606) 432-0111

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 40946 | KY | Yes |

## Other

- **Enumeration date:** 05/22/2014
- **Last updated:** 05/22/2014