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Organization

O C H INTERNAL MEDICINE

Active
Other names
OCH Internal Medicine
Organization subpart
No

Provider details

NPI number
Authorized official
JENNIFER DAUGHERTY (PFS DIRECTOR)
(270) 504-1910
Entity
Organization

Contact information

Practice address
1215 OLD MAIN ST, HARTFORD, KY 42347-1619
(270) 298-5404
(270) 298-5285
Mailing address
1215 OLD MAIN ST, HARTFORD, KY 42347-1619
(270) 298-5404
(270) 298-5285

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
34484
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000196674
BLUE CROSS AND CLUE SHIEL
KS
05
65922247
KY
01
G91153
MEDICARE UPIN NUMBER
KY
Enumeration date
07/17/2006
Last updated
03/19/2024
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