Organization
ST. JOHN NEUMANN'S EXTENDED HOURS CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. THERESA MERCED (OFFICE MANAGER)
(606) 666-4011
Entity
Organization
Contact information
Practice address
1389 HIGHWAY 15 NORTH, JACKSON, KY 41339
(606) 666-4011
(606) 666-5801
Mailing address
PO BOX 606, JACKSON, KY 41339-0606
(606) 666-4011
(606) 666-5801
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
KY24420
KY
Other
Enumeration date
10/05/2007
Last updated
10/05/2007
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