Organization
BLUEGRASS RURAL HEALTH CLINIC, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KISHORE JADHAV MD (PRESIDENT)
(606) 658-2710
Entity
Organization
Contact information
Practice address
2734 S HIGHWAY 421, MANCHESTER, KY 40962-7515
(606) 658-2710
(606) 658-2712
Mailing address
151 N EAGLE CREEK DR, STE 12, LEXINGTON, KY 40509-1889
(859) 263-4341
(859) 263-7441
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
33372
KY
363L00000X
Nurse Practitioner
255P
KY
Other
Enumeration date
07/18/2008
Last updated
07/18/2008
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