Organization
FAMILY CARE CENTER NORTH HARDIN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFF D KINGERY (DIRECTOR)
(270) 706-1046
Entity
Organization
Contact information
Practice address
1370 ROGERSVILLE RD, RADCLIFF, KY 40160-9344
(270) 706-1131
(270) 351-8031
Mailing address
PO BOX 2309, ELIZABETHTOWN, KY 42702-2309
(270) 706-1131
(270) 706-1167
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
PA241
KY
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65902611
—
KY
Enumeration date
05/12/2006
Last updated
09/17/2009
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