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Individual

MRS. AMY LANKFORD JONES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
353 BOGLE ST, SUITE C, SOMERSET, KY 42503-2888
(606) 678-2220
(606) 678-2219
Mailing address
353 BOGLE ST, SUITE C, SOMERSET, KY 42503-2888
(606) 678-2220
(606) 678-2219

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA679
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000505007
BCBS INDIVIDUAL #
KY
01
00196
MEDICARE GROUP PIN#
01
7100016460
KY MEDICAID GROUP #
KY
05
95001780
KY
Enumeration date
08/17/2005
Last updated
12/04/2012
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