Organization
EAST BERNSTADT MEDICAL CLINIC
Active
Other names
London Corbin Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CARLA JEAN JOHNSON CPC (INS. BILLING CREDENTIALING CLERK)
(606) 843-6195
Entity
Organization
Contact information
Practice address
US HWY 25 SOUTH, US HWY 25 SOUTH, LILY, KY 40740
(606) 523-1660
(606) 523-1665
Mailing address
US HWY 25 SOUTH, US HWY 25 SOUTH, LILY, KY 40740
(606) 523-1660
(606) 523-1665
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65916660
—
KY
Enumeration date
03/23/2006
Last updated
11/29/2007
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