Organization
FAMILY PRACTICE CLINIC OF BOONEVILLE, INC.
Active
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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