Organization
FAMILY & INTERNAL MEDICINE ASSOCIATES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JIM OSBOURNE (OFFICE ADMINISTRATOR)
(270) 699-9500
Entity
Organization
Contact information
Practice address
325 W WALNUT ST, STE 600, LEBANON, KY 40033-1378
(270) 699-9500
(270) 699-9550
Mailing address
325 W WALNUT ST, STE 600, LEBANON, KY 40033-1378
(270) 699-9500
(270) 699-9550
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1077750
PASSPORT
KY
01
—
18D0320437
CLIA
KY
01
—
2435329002
PASSPORT ADVANTAGE
KY
05
—
35002005
—
KY
05
—
65932105
—
KY
Enumeration date
07/13/2005
Last updated
10/02/2019
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