Organization
AARON K. JONAN MEMORIAL CLINIC INC.
Active
Other names
Aaron Jonan Memorial Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DJIEN SO (ADMINISTRATOR/ACCESS MANAGER)
(606) 794-5600
Entity
Organization
Contact information
Practice address
832 HIGHWAY 15 N, JACKSON, KY 41339-8284
(606) 666-5142
(606) 666-4172
Mailing address
832 HIGHWAY 15 N, JACKSON, KY 41339-8284
(606) 666-5142
(606) 666-4172
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
43629
KY
261QR1300X
Rural Health Clinic/Center
Primary
900029
KY
363LF0000X
Family Nurse Practitioner
3006826
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100336880
—
KY
Enumeration date
08/01/2006
Last updated
05/09/2023
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