Organization
LINCOLN TRAIL MEDICAL ASSOC., PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAWED M MOVANIA MD (OWNER)
(270) 351-3192
Entity
Organization
Contact information
Practice address
700 W LINCOLN TRAIL BLVD, RADCLIFF, KY 40160-2604
(270) 351-3192
(270) 351-5499
Mailing address
700 W LINCOLN TRAIL BLVD, RADCLIFF, KY 40160-2604
(270) 351-3192
(270) 351-5499
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
31578
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000047366
ANTHEM ID #
KY
05
—
64315781
—
KY
Enumeration date
02/21/2006
Last updated
06/22/2010
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