Organization
ACS PRIMARY CARE PHYSICIANS-MIDWEST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDAL L DABBS M.D. (PRESIDENT)
(865) 693-1000
Entity
Organization
Contact information
Practice address
150 N EAGLE CREEK DR, LEXINGTON, KY 40509-1805
(859) 967-5000
Mailing address
PO BOX 633815, CINCINNATI, OH 45263-3815
(888) 203-1274
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
—
—
208000000X
Pediatrics Physician
—
—
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000197128
ANTHEM BCBS OF KENTUCKY
KY
01
—
1172638
PASSPORT MEDICAID HEALTH PLAN
KY
01
—
2441613
PASSPORT ADVANTAGE CARE
KY
05
—
65938102
—
KY
Enumeration date
06/17/2006
Last updated
12/27/2022
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