Organization
BAPTIST MEDICAL MANAGEMENT SERVICES INC
Active
Other names
BAPTIST HEALTH EXPRESS CARE
Organization subpart
No
Provider details
NPI number
Authorized official
E BERTON WHITAKER (CEO)
(270) 825-5857
Entity
Organization
Contact information
Practice address
1756 E CENTER ST, MADISONVILLE, KY 42431-2253
(270) 821-3300
(270) 821-2100
Mailing address
900 HOSPITAL DR, MADISONVILLE, KY 42431-1644
(270) 825-5100
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
KY
207R00000X
Internal Medicine Physician
—
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
689131
ANTHEM GROUP #
KY
05
—
7100149860
—
KY
01
—
7100192750
MEDICAID PHYSICIAN GROUP#
KY
Enumeration date
10/27/2010
Last updated
04/24/2013
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