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Organization
DAMON GATEWOOD MD PLLC
Active
Organization
DAMON GATEWOOD MD PLLC
Active
Other names
Kentucky River Medical Partners
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAMON L GATEWOOD MD (OWNER)
(502) 532-7341
Entity
Organization
Contact information
Practice address
58 CITATION LANE, CAMPBELLSBURG, KY 40011-1426
(502) 532-7341
(502) 532-0127
Mailing address
58 CITATION LANE, CAMPBELLSBURG, KY 40011-1426
(502) 532-7341
(502) 532-0127
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
37028
KY
363LF0000X
Family Nurse Practitioner
3007904
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50003253
PASSPORT HEALTH PLAN
KY
05
—
7100268000
—
KY
05
—
7100282440
—
KY
Enumeration date
11/15/2006
Last updated
06/05/2014
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