Organization
LAWRENCEBURG CLINIC MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH E HINES M.D. (OWNER)
(502) 839-5592
Entity
Organization
Contact information
Practice address
504 W BROADWAY ST, SUITE B, LAWRENCEBURG, KY 40342-1541
(502) 839-5592
(502) 839-1041
Mailing address
504 W BROADWAY ST, SUITE B, LAWRENCEBURG, KY 40342-1541
(502) 839-5592
(502) 839-1041
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1174516306
INDIVIDUAL NPI NUMBER
KY
01
—
4500041100
EPSDT
KY
05
—
65916165
—
KY
Enumeration date
12/28/2006
Last updated
05/22/2015
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