Organization
EAST BERNSTADT MEDICAL CLINIC PLLC
Active
Other names
McKee Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MISS CARLA J JOHNSON (BILLING/CREDENTIALING MANAGER)
(606) 843-6195
Entity
Organization
Contact information
Practice address
US HWY 290, CAMPBELL DRUG BLDG, MCKEE, KY 40447-0757
(606) 287-5162
(606) 287-8034
Mailing address
PO BOX 757, MCKEE, KY 40447-0757
(606) 287-5162
(606) 287-8034
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
KY
261QR1300X
Rural Health Clinic/Center
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
35001734
—
KY
05
—
7100163260
—
KY
Enumeration date
03/23/2006
Last updated
12/16/2024
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