Organization
GENESIS ENTERPRISES, INC.
Active
Other names
Family Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
WILLOW ROUBEN (CFO)
(270) 384-9934
Entity
Organization
Contact information
Practice address
1463 CAMPBELLSVILLE RD, COLUMBIA, KY 42728-2263
(270) 384-9934
(270) 384-2823
Mailing address
1463 CAMPBELLSVILLE RD, COLUMBIA, KY 42728-2263
(270) 384-9934
(270) 384-2823
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
35001239
—
KY
Enumeration date
12/21/2006
Last updated
07/21/2022
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