Organization
SOUTHERN MEDICAL PARTNERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BENNY RAY BAILEY II (CEO)
(606) 435-1708
Entity
Organization
Contact information
Practice address
277 ROY CAMPBELL DR, HAZARD, KY 41701-9485
(606) 435-1708
(606) 435-2445
Mailing address
277 ROY CAMPBELL DR, HAZARD, KY 41701-9485
(606) 435-1708
(606) 435-2445
Taxonomy
Speciality
Code
Description
License number
State
261QE0002X
Emergency Care Clinic/Center
Primary
34644
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34644
MEDICAL LICENSURE
KY
Enumeration date
07/21/2006
Last updated
08/22/2020
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