# MY 3 C'S ENTERPRISES, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MY 3 C'S ENTERPRISES, PLLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902027865
- **Authorized official:** MRS. TIFFANY NICHOLE DUNAGAN CPC (BILLING MANAGER)
- **Authorized official phone:** (270) 432-4800

## Contact information

- **Practice address:** 1704 W STOCKTON ST, EDMONTON, KY 42129-8137
- **Practice address phone:** (270) 432-4800
- **Practice address fax:** (270) 432-4804
- **Mailing address:** 1704 W STOCKTON ST, EDMONTON, KY 42129-8137
- **Mailing address phone:** (270) 432-4800
- **Mailing address fax:** (270) 432-4804

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | 35818 | KY | Yes |

## Other

- **Enumeration date:** 05/01/2007
- **Last updated:** 01/10/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000259528 | BLUE CROSS | KY |
| 05 | — | 64029440 | — | KY |