Organization
SAINT JOSEPH MEDICAL FOUNDATION, INC
Active
Parent organization
SAINT JOSEPH MEDICAL FOUNDATION, INC
Other names
Draper Family Practice
Organization subpart
Yes
Provider details
NPI number
Legal business name
SAINT JOSEPH MEDICAL FOUNDATION, INC
Authorized official
KANDI R REA (PHYSICIAN CREDENTIALING)
(606) 330-3404
Entity
Organization
Contact information
Practice address
1250 KEENE RD, STE 102, NICHOLASVILLE, KY 40356
(859) 885-9402
(859) 887-1624
Mailing address
PO BOX 73652, CLEVELAND, OH 44193-0002
(606) 330-3404
(606) 330-3100
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
17955
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65928590
—
KY
Enumeration date
01/15/2009
Last updated
01/15/2009
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