Organization
SALYERSVILLE MEDICAL CENTER, LLC
Active
Organization
SALYERSVILLE MEDICAL CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DJIEN SO (ADMINISTRATOR)
(606) 794-5600
Entity
Organization
Contact information
Practice address
268 E MAPLE ST, SALYERSVILLE, KY 41465-8032
(606) 349-5300
(606) 349-5312
Mailing address
PO BOX 2688, PIKEVILLE, KY 41502-2688
(606) 432-2748
(606) 437-0438
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
900116
KY
363LF0000X
Family Nurse Practitioner
3007841
KY
363LF0000X
Family Nurse Practitioner
3008377
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100315420
—
KY
Enumeration date
05/28/2006
Last updated
05/09/2023
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