Organization
MARYMOUNT MEDICAL CENTER PHYSICIAN SERVICES
Active
Other names
MMC Physician Services
Organization subpart
No
Provider details
NPI number
Authorized official
CARMEL JONES (COO)
(606) 330-6015
Entity
Organization
Contact information
Practice address
1001 SAINT JOSEPH LN, LONDON, KY 40741-8345
(606) 330-6000
Mailing address
740 E LAUREL RD, LONDON, KY 40741-8601
(606) 330-7823
(606) 330-7825
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
74900986
—
KY
Enumeration date
06/21/2007
Last updated
11/27/2012
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