Organization
PIKEVILLE MEDICAL CENTER INC.
Active
Other names
Pikeville Medical Center Clinic @ Walmart
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE HAGY (CFO)
(606) 218-3500
Entity
Organization
Contact information
Practice address
254 CASSIDY BLVD, PIKEVILLE, KY 41501-1426
(606) 437-0123
(606) 218-4788
Mailing address
PO BOX 432, PIKEVILLE, KY 41502-0432
(606) 218-3500
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
1300366
KY
261Q00000X
Clinic/Center
Primary
—
—
363A00000X
Physician Assistant
1300366
KY
363L00000X
Nurse Practitioner
1300366
KY
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65922361
—
KY
05
—
7100152490
—
KY
05
—
7100155680
—
KY
05
—
7100155700
—
KY
05
—
7100155720
—
KY
05
—
7100155970
—
KY
Enumeration date
06/10/2010
Last updated
10/19/2016
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