Organization
GREAT PHYSICIAN HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL BRIAN HUMBLE MD (OWNER)
(270) 726-9568
Entity
Organization
Contact information
Practice address
975 HOPKINSVILLE RD, RUSSELLVILLE, KY 42276-9774
(270) 726-9568
(270) 726-9570
Mailing address
975 HOPKINSVILLE RD, RUSSELLVILLE, KY 42276-9774
(270) 726-9568
(270) 726-9570
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
42900
KY
Other
Enumeration date
07/01/2009
Last updated
09/08/2009
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