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Organization

PRIORITY PRIMARY CARE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KUMARASOORIYAR KUMARAVELU MD (OWNER)
(270) 632-4514
Entity
Organization

Contact information

Practice address
60 SHELTON LN, RUSSELLVILLE, KY 42276-7203
(270) 632-4514
(270) 632-4518
Mailing address
PO BOX 1546, RUSSELLVILLE, KY 42276-3546
(270) 632-4514
(270) 632-4518

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
261QR1300X
Rural Health Clinic/Center
Primary
363L00000X
Nurse Practitioner

Other

Enumeration date
12/15/2016
Last updated
03/02/2018
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