Organization
WAYNESBURG CLINIC, PLLC
Active
Organization
WAYNESBURG CLINIC, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTOPHER DUVALL SIMS M.D. (MEDICAL DIRECTOR)
(606) 365-1547
Entity
Organization
Contact information
Practice address
14098 US HIGHWAY 27 S, WAYNESBURG, KY 40489-8253
(606) 379-6646
(606) 379-5707
Mailing address
PO BOX 435, WAYNESBURG, KY 40489-0435
(606) 379-6646
(606) 379-5707
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
900205
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00361
MEDICARE PART B
KY
01
—
183954
MEDICARE PART A
KY
05
—
7100019500
—
KY
Enumeration date
07/10/2007
Last updated
10/04/2023
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