Organization
COMMONWEALTH MEDICAL CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATT BEAVIN (OWNER)
(859) 338-3958
Entity
Organization
Contact information
Practice address
989 GOVERNORS LN, SUITE 220, LEXINGTON, KY 40513-1173
(859) 338-3958
(859) 368-8135
Mailing address
989 GOVERNORS LN, SUITE 240, LEXINGTON, KY 40513-1173
(859) 338-3958
(859) 368-8135
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
05/01/2017
Last updated
10/19/2017
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