Organization
APPALACHIAN PHYSICIANS PSC
Active
Organization
APPALACHIAN PHYSICIANS PSC
Active
Other names
Appalachian Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEEPAK SRIVASTAVA MD (PRESIDENT)
(606) 279-2771
Entity
Organization
Contact information
Practice address
5923 HWY 80, WOOTON, KY 41776
(606) 598-5104
(606) 598-0983
Mailing address
509 MEMORIAL DR STE 2, MANCHESTER, KY 40962-6196
(606) 598-5104
(606) 598-0983
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
07/12/2006
Last updated
11/08/2019
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