Organization
MANCHESTER FAMILY PRACTICE CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT A. CARTER JR. (PRESIDENT)
(606) 528-0283
Entity
Organization
Contact information
Practice address
2734 S HIGHWAY 421, MANCHESTER, KY 40962-7515
(606) 599-0603
(606) 599-8419
Mailing address
PO BOX 1125, CORBIN, KY 40702-1125
(606) 528-0283
(606) 528-8422
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
255P
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
35-001072
—
KY
Enumeration date
05/31/2005
Last updated
08/22/2020
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