Organization
MY 3 C'S ENTERPRISES, PLLC
Active
Other names
MY 3 C'S ENTERPRISES, PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TIFFANY NICHOLE DUNAGAN CPC (BILLING MANAGER)
(270) 432-4800
Entity
Organization
Contact information
Practice address
1704 W STOCKTON ST, EDMONTON, KY 42129-8137
(270) 432-4800
(270) 432-4804
Mailing address
1704 W STOCKTON ST, EDMONTON, KY 42129-8137
(270) 432-4800
(270) 432-4804
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
35818
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000259528
BLUE CROSS
KY
05
—
64029440
—
KY
Enumeration date
05/01/2007
Last updated
01/10/2012
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