Organization
MOUNTAIN VIEW FAMILY PRACTICE PLLC
Active
Other names
MOUNTAIN VIEW FAMILY PRACTICE
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMUEL DUANE KREIS I M.D. (CEO/DOCTOR)
(606) 877-2850
Entity
Organization
Contact information
Practice address
272 LONDON MOUNTAIN VIEW DR, LONDON, KY 40741-6601
(606) 877-2850
(606) 877-2857
Mailing address
272 LONDON MOUNTAIN VIEW DR, LONDON, KY 40741-6601
(606) 877-2850
(606) 877-2857
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65944589
—
KY
05
—
7100140520
—
KY
01
—
DE2149
RAILROAD MEDICARE
KY
01
—
P00278839
RAILROAD MEDICARE
KY
Enumeration date
10/16/2007
Last updated
09/17/2019
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