Organization
EAST KENTUCKY MEDICAL GROUP, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LELA C JOHNSON M.D. (PRESIDENT)
(606) 432-2172
Entity
Organization
Contact information
Practice address
50 WEDDINGTON BRANCH RD, SUITE B, PIKEVILLE, KY 41501-3296
(606) 432-2172
(606) 433-0143
Mailing address
50 WEDDINGTON BRANCH RD, SUITE B, PIKEVILLE, KY 41501-3296
(606) 432-2172
(606) 433-0143
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100105940
—
KY
Enumeration date
11/08/2005
Last updated
04/30/2014
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