Organization
INDEPENDENCE FAMILY PRACTICE P S C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN FRANKLIN ALLNUTT MD (PRESIDENT)
(859) 363-8600
Entity
Organization
Contact information
Practice address
5290 MADISON PIKE, STE 100, INDEPENDENCE, KY 41051
(859) 363-8600
(859) 960-0003
Mailing address
5290 MADISON PIKE, STE 100, INDEPENDENCE, KY 41051
(859) 363-8600
(859) 960-0003
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
22978
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000370204
ANTHEM
—
Enumeration date
01/07/2008
Last updated
01/07/2008
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