Organization
LICKING VALLEY INTERNAL MEDICINE & PEDIATRICS PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM FRANK MCKEMIE JR. MD (PRESIDENT)
(859) 234-9611
Entity
Organization
Contact information
Practice address
1210 KY HIGHWAY 36 E, SUITE 2A, CYNTHIANA, KY 41031-7490
(859) 234-9611
(859) 235-0878
Mailing address
1210 KY HIGHWAY 36 E, SUITE 2A, CYNTHIANA, KY 41031-7490
(859) 234-9611
(859) 235-0878
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
363A00000X
Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65934341
—
KY
Enumeration date
09/21/2006
Last updated
04/07/2010
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