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Organization

FEP OF KENTUCKY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MARTIN FEDKO MD (CEO)
(847) 571-2467
Entity
Organization

Contact information

Practice address
320 W 18TH ST, HOPKINSVILLE, KY 42240-1965
(505) 287-4446
Mailing address
3030 NW EXPRESSWAY STE 1000, OKLAHOMA CITY, OK 73112-5468
(800) 962-3303

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
363A00000X
Physician Assistant
363L00000X
Nurse Practitioner

Other

Enumeration date
08/09/2023
Last updated
11/30/2023
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