Organization
INTERNAL MEDICINE ASSOCIATES OF KY PSC
Active
Other names
Internal Medicine Associates of KY PSC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GINA DCOSTA MD (DOCTOR)
(606) 864-2179
Entity
Organization
Contact information
Practice address
2135 HIGHWAY 30 BYP, SUITE 1, LONDON, KY 40741-6139
(606) 864-2179
Mailing address
2135 HIGHWAY 30 BYP, SUITE 1, LONDON, KY 40741-6139
(606) 864-2179
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
39044
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64094576
—
KY
Enumeration date
07/02/2006
Last updated
08/22/2020
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