Organization
CRESTWOOD FAMILY MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD ARTHUR HEFNER D.O. (OWNER)
(502) 243-3161
Entity
Organization
Contact information
Practice address
6106 CRESTWOOD STA STE A, CRESTWOOD, KY 40014-9473
(502) 243-3161
(502) 243-3164
Mailing address
6106 CRESTWOOD STA STE A, CRESTWOOD, KY 40014-9473
(502) 243-3161
(502) 243-3164
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02614
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64000391
—
KY
Enumeration date
07/29/2006
Last updated
08/22/2020
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