Organization
MARTIN COUNTY RURAL HEALTH CLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTOIN HANA MD (OWNER)
(606) 886-1173
Entity
Organization
Contact information
Practice address
64 KIRK PLZ, INEZ, KY 41224-6501
(606) 298-2520
(606) 298-2522
Mailing address
PO BOX 697, PRESTONSBURG, KY 41653-0697
(606) 886-1173
(606) 886-2193
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64126055
—
KY
Enumeration date
03/17/2014
Last updated
11/02/2017
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