Organization
EPHRAIM MCDOWELL HEALTH RESOURCE, INC.
Active
Other names
Fort Logan Walk-in & Primary Care
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA KINMAN (CFO)
(859) 239-2424
Entity
Organization
Contact information
Practice address
110 METKER TRL, STANFORD, KY 40484-1065
(606) 365-3360
Mailing address
PO BOX 990, DANVILLE, KY 40423-0990
(859) 239-2379
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
900145
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
35001478
—
KY
Enumeration date
01/24/2007
Last updated
12/30/2021
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