Organization
EADENS-GRIMBALL INTERNAL MEDICINE ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEBRA JO EADENS M.D. (PHYSICIAN/OFFICE MANAGER)
(606) 451-9953
Entity
Organization
Contact information
Practice address
402 BOGLE ST, STE 3, SOMERSET, KY 42503-2870
(606) 451-9953
(606) 451-1533
Mailing address
402 BOGLE ST, STE 3, SOMERSET, KY 42503-2870
(606) 451-9953
(606) 451-1533
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100049580
—
KY
Enumeration date
10/10/2006
Last updated
02/16/2015
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