Organization
MAYFIELD PEDIATRIC CLINIC PLLC
Active
Other names
Mayfield Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
ABID HUSSAIN M.D. (OWNER)
(270) 247-1104
Entity
Organization
Contact information
Practice address
417 S 6TH ST, MAYFIELD, KY 42066
(270) 247-1104
(270) 247-1107
Mailing address
417 S. 6TH ST., MAYFIELD, KY 42066
(270) 247-1104
(270) 247-1107
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
41115
KY
208000000X
Pediatrics Physician
41115
KY
208000000X
Pediatrics Physician
Primary
—
—
208D00000X
General Practice Physician
41115
KY
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100059060
—
KY
Enumeration date
04/07/2009
Last updated
07/19/2018
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