Organization
EASTERN KY MEDICAL CLINICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA LYNN TERRY (OWNER)
(606) 789-1223
Entity
Organization
Contact information
Practice address
169 GOBLE BR, HAGERHILL, KY 41222-8639
(606) 789-1223
(606) 789-9313
Mailing address
169 GOBLE BR, HAGERHILL, KY 41222-8639
(606) 789-1223
(606) 789-9313
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65933566
—
KY
Enumeration date
07/19/2007
Last updated
07/19/2007
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