Organization
SOUTHERN KENTUCKY PRIMARY CARE, P.S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATISHA EDMONDS (OFFICE ADMINISTRATOR)
(270) 265-2574
Entity
Organization
Contact information
Practice address
101 W 2ND ST, RUSSELLVILLE, KY 42276
(270) 881-1813
(270) 886-6600
Mailing address
1739 CANTON ST, HOPKINSVILLE, KY 42240-1991
(270) 881-1813
(270) 886-6008
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
KY
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
10/12/2017
Last updated
06/15/2018
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