Organization
CHILDREN'S CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANNA FAYE SIMS (ASST. OFFICE MANAGER)
(606) 678-8155
Entity
Organization
Contact information
Practice address
350 LANGDON ST, SOMERSET, KY 42503-2786
(606) 678-8155
(606) 678-7548
Mailing address
350 LANGDON ST, SOMERSET, KY 42503-2786
(606) 678-8155
(606) 678-7548
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65911968
—
KY
Enumeration date
01/24/2006
Last updated
09/17/2009
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