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Organization

INTERNAL MEDICINE ASSOCIATES OF KY PSC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JUDY M ULRICH (OFFICE MANAGER)
(606) 864-2179
Entity
Organization

Contact information

Practice address
2135 HIGHWAY 30, SUITE 1, LONDON, KY 40741-6139
(606) 864-2179
Mailing address
2135 HIGHWAY 30, SUITE 1, LONDON, KY 40741
(606) 864-2179

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
363L00000X
Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
65943672
KY
05
7100019100
KY
Enumeration date
07/07/2006
Last updated
04/08/2009
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