Organization
BAPTIST HEALTH MEDICAL GROUP INC
Active
Organization
BAPTIST HEALTH MEDICAL GROUP INC
Active
Other names
Rural Health Clinic Williamsburg
Organization subpart
No
Provider details
NPI number
Authorized official
DANYEL D CLAY (VP REVENUE CYCLE)
(502) 253-4911
Entity
Organization
Contact information
Practice address
403 SYCAMORE ST, WILLIAMSBURG, KY 40769-1153
(606) 549-8244
(606) 549-8354
Mailing address
1901 CAMPUS PL, LOUISVILLE, KY 40299-2308
(502) 253-4911
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
900279
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18-8940
MEDICARE
KY
05
—
7100336420
—
KY
Enumeration date
06/29/2018
Last updated
07/22/2024
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