Organization
INTEGRA HEALTHCARE ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA O GATTERDAM (MEMBER)
(240) 271-8962
Entity
Organization
Contact information
Practice address
4071 TATES CREEK CENTRE DR STE 101, LEXINGTON, KY 40517-3063
(859) 396-3050
Mailing address
4108 CLEARWATER WAY, LEXINGTON, KY 40515-6000
(859) 396-3050
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
Other
Enumeration date
11/23/2020
Last updated
01/31/2023
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