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Organization

INTERNAL MEDICINE ASSOCIATES PSC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JEANNIE MOBERLY MANAGER (OFFICE MANAGER)
(859) 276-4486
Entity
Organization

Contact information

Practice address
1401 HARRODSBURG RD, SUITE B-160, LEXINGTON, KY 40504-3751
(859) 276-4486
(859) 277-9164
Mailing address
1401 HARRODSBURG RD, SUITE B-160, LEXINGTON, KY 40504-3751
(859) 276-4486
(859) 277-9164

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
65924193
KY
01
CL6978
RAILROAD MEDICARE
KY
Enumeration date
01/24/2007
Last updated
10/19/2010
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