Organization
EASTERN KENTUCKY TREATMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN CONN (MANAGER)
(606) 616-2391
Entity
Organization
Contact information
Practice address
6800 US HIGHWAY 23 S STE 2&3, PIKEVILLE, KY 41501-3701
(606) 637-2479
Mailing address
6800 US HIGHWAY 23 S STE 2&3, PIKEVILLE, KY 41501-3701
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
811034
OFFICE OF INSPECTOR GENERAL
KY
05
—
PENDING
—
KY
Enumeration date
02/28/2022
Last updated
02/28/2022
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