Organization
BRUCE L KINNEY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA WILLIAMS (BILLING COORDINATOR)
(606) 478-4287
Entity
Organization
Contact information
Practice address
5000 KY ROUTE 321 STE 2127, PRESTONSBURG, KY 41653-9113
(606) 478-4287
Mailing address
PO BOX 949, PAINTSVILLE, KY 41240-0949
(606) 478-4287
Taxonomy
Speciality
Code
Description
License number
State
207VX0000X
Obstetrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000384921
ANTHEM BLUE CROSS
KY
05
—
64097256
—
KY
01
—
DE8139
RAILROAD MEDICARE
KY
Enumeration date
10/31/2007
Last updated
10/31/2007
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