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Organization

KENTUCKY INPATIENT MEDICINE ASSOCIATES, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TALBOT GREEN MCCORMICK III MD (PRESIDENT)
(678) 441-8508
Entity
Organization

Contact information

Practice address
1 SAINT JOSEPH DR, SAINT JOSEPH HOSPITAL,, LEXINGTON, KY 40504-3742
(859) 313-2963
(785) 623-5045
Mailing address
5901-C PEACHTREE-DUNWOODY ROAD, SUITE 350, ATLANTA, GA 30328-7159
(678) 441-8556
(678) 441-8656

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
KY
207Q00000X
Family Medicine Physician
KY
207R00000X
Internal Medicine Physician
KY
208D00000X
General Practice Physician
KY
208M00000X
Hospitalist Physician
Primary
KY
363A00000X
Physician Assistant
KY
363L00000X
Nurse Practitioner
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
33J2
BCBS - GROUP
KY
05
65901613
KY
01
78901162
KY MEDICAID - NP GROUP
KY
01
CH2140
RR MEDICARE - GROUP
KY
Enumeration date
05/03/2006
Last updated
04/09/2015
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