Organization
GOOD DOCTOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID CARTER (CREDENTIALING MANAGER)
(859) 737-0904
Entity
Organization
Contact information
Practice address
9405 US HIGHWAY 235, STANVILLE, KY 41659-9048
(606) 899-2273
(606) 899-2273
Mailing address
4145 NORTH MAYO TRAIL, BOX 252, PIKEVILLE, KY 41501-3211
(606) 899-2273
(606) 899-2273
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
01/19/2019
Last updated
01/19/2019
Update your record
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