Organization
PHYSICIANS FOR FAMILIES PSC
Active
Other names
Fort Logan Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KAREN CLICK (OFFICE MANAGER)
(606) 365-9181
Entity
Organization
Contact information
Practice address
126 PORTMAN AVE, STANFORD, KY 40484-1230
(606) 365-9181
(606) 365-9183
Mailing address
126 PORTMAN AVE, STANFORD, KY 40484-1230
(606) 365-9181
(606) 365-9183
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
17220
KY
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64-172208
—
KY
05
—
65902140
—
KY
05
—
7100228860
—
KY
Enumeration date
10/23/2006
Last updated
06/21/2018
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