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Organization

PRIMECARE PSC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DAVID J. ZOELLER MD (PHYSICIAN/OWNER)
(270) 765-4535
Entity
Organization

Contact information

Practice address
2413 RING RD STE 110, ELIZABETHTOWN, KY 42701-5924
(270) 765-4535
(270) 763-1901
Mailing address
2413 RING RD STE 110, ELIZABETHTOWN, KY 42701-5924
(270) 765-4535
(270) 763-1901

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
26429
KY
207QA0401X
Addiction Medicine (Family Medicine) Physician
363AM0700X
Medical Physician Assistant
363L00000X
Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1507510
TN
05
65922940
KY
05
7100060440
KY
05
78904083
KY
Enumeration date
11/28/2005
Last updated
11/17/2022
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