Organization
VILLAGEMD KENTUCKY, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WENDY LEE RUBAS (GENERAL COUNSEL)
(312) 465-7898
Entity
Organization
Contact information
Practice address
1000 S 12TH ST, MURRAY, KY 42071
(270) 759-9200
(270) 759-8368
Mailing address
125 S CLARK ST STE 900, CHICAGO, IL 60603-5200
(312) 465-7900
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
TP057
KY
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
TP057
KY
225100000X
Physical Therapist
TP057
KY
Other
Enumeration date
07/17/2017
Last updated
05/17/2018
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