Organization
FLAGET HEALTHCARE INC
Active
Other names
FLAGET IMMEDIATE CARE CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN C BRADFORD (CHIEF FINANCIAL OFFICER)
(502) 350-5000
Entity
Organization
Contact information
Practice address
110 S SALEM DR, BARDSTOWN, KY 40004-1761
(502) 348-3400
(502) 350-5022
Mailing address
PO BOX 1160, BARDSTOWN, KY 40004-4160
(502) 348-3400
(502) 350-5022
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
35000645
—
KY
01
—
50018276
PASSPORT HEALTH PLAN
KY
Enumeration date
12/14/2006
Last updated
06/25/2008
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