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Organization
MEMORIAL HOSPITAL, INC.
Active
Organization
MEMORIAL HOSPITAL, INC.
Active
Other names
AdventHealth Wound Care At Manchester, AdventHealth Medical Group Manchester
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SISSEL JACOB (CEO)
(606) 598-5104
Entity
Organization
Contact information
Practice address
515 MEMORIAL DR STE 1, MANCHESTER, KY 40962-9157
(606) 598-4524
(606) 599-2554
Mailing address
210 MARIE LANGDON DR, MANCHESTER, KY 40962-6388
(606) 598-5104
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
NULL
208000000X
Pediatrics Physician
—
—
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
07/15/2009
Last updated
02/09/2023
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