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Organization

MEMORIAL HOSPITAL, INC.

Active
Other names
Mountain Medical Associates of London
Organization subpart
No

Provider details

NPI number
Authorized official
MR. BENNY NOLEN (VICE PRESIDENT)
(606) 598-5104
Entity
Organization

Contact information

Practice address
102 PROFESSIONAL DR, SUITE 3, LONDON, KY 40741-8857
(606) 864-2788
(606) 864-2797
Mailing address
509 MEMORIAL DR, SUITE 2, MANCHESTER, KY 40962-6195
(606) 598-5104
(606) 598-0983

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
65934523
KY
Enumeration date
05/14/2008
Last updated
01/13/2021
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