Organization
SHELBY FAMILY MEDICINE PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUBY V CHAMBERS (OFFICE MANAGER)
(502) 633-4622
Entity
Organization
Contact information
Practice address
60 MACK WALTERS RD, SHELBYVILLE, KY 40065-1738
(502) 633-4622
(502) 633-6925
Mailing address
60 MACK WALTERS RD, SHELBYVILLE, KY 40065-1738
(502) 633-4622
(502) 633-6925
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1060094
PASSPORT
KY
01
—
2434179001
PASSPORT ADVANTAGE
KY
05
—
65934812
—
KY
01
—
CJ0303
RAILROAD MEDICARE PIN
—
Enumeration date
10/20/2006
Last updated
10/26/2007
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