Organization
EAST KY HEALTH SERVICE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BENNY RAY BAILEY PH.D. (EXECUTIVE DIRECTOR)
(606) 785-3164
Entity
Organization
Contact information
Practice address
566 HIGHWAY 899, HINDMAN, KY 41822-0849
(606) 785-3164
(606) 785-0107
Mailing address
PO BOX 849, 566 HWY 899, HINDMAN, KY 41822-0849
(606) 785-3164
(606) 785-0107
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
6629
KY
261QP2300X
Primary Care Clinic/Center
700002
KY
363LP2300X
Primary Care Nurse Practitioner
Primary
3008325
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65924300
—
KY
Enumeration date
09/14/2006
Last updated
06/10/2021
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