Organization
FAMILY PRACTICE CLINIC OF BOONEVILLE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM COX APRN (OWNER OPERATOR)
(606) 593-6023
Entity
Organization
Contact information
Practice address
200 MULBERRY ST, SUITE A, BOONEVILLE, KY 41314-7505
(606) 593-6023
(606) 593-6087
Mailing address
PO BOX 737, 200 MULBERRY STREET, SUITE A, BOONEVILLE, KY 41314-0737
(606) 593-6023
(606) 593-6087
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100159610
—
KY
Enumeration date
08/18/2006
Last updated
12/22/2015
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