Organization
COMMONWEALTH OF KENTUCKY
Active
Organization
COMMONWEALTH OF KENTUCKY
Active
Parent organization
COMMONWEALTH OF KENTUCKY
Other names
Outwood Specialty Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
COMMONWEALTH OF KENTUCKY
Authorized official
WENDY MORRIS (DEPUTY COMMISSIONER)
(502) 564-4527
Entity
Organization
Contact information
Practice address
23524 DAWSON SPRINGS RD, DAWSON SPRINGS, KY 42408-9205
(270) 797-3771
(270) 797-3592
Mailing address
23524 DAWSON SPRINGS RD, DAWSON SPRINGS, KY 42408-9205
(270) 797-3771
(270) 797-3592
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
04/11/2014
Last updated
04/11/2014
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