Organization
JACKSON PURCHASE MEDICAL ASSOCIATES, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARMEL BROWN (DIRECTOR OF FINANCE)
(270) 538-5866
Entity
Organization
Contact information
Practice address
225 MEDICAL CENTER DR, SUITE 201, PADUCAH, KY 42003
(270) 441-4200
(270) 441-4398
Mailing address
225 MEDICAL CENTER DR STE 206, PADUCAH, KY 42003-7914
(270) 441-4522
(270) 441-4822
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
207RN0300X
Nephrology Physician
—
—
208000000X
Pediatrics Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65923831
—
KY
Enumeration date
10/25/2006
Last updated
06/08/2018
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