Organization
GLENN R. WOMACK M.D. PSC
Active
Other names
Buffalo Trace Family Health Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GLENN R WOMACK M.D. (PRESIDENT)
(606) 849-2323
Entity
Organization
Contact information
Practice address
732 ELIZAVILLE ROAD, FLEMINGSBURG, KY 41041
(606) 849-2323
(606) 849-2025
Mailing address
732 ELIZAVILLE ROAD, PO BOX 344, FLEMINGSBURG, KY 41041
(606) 849-2323
(606) 849-2025
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
15952
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65929143
—
KY
05
—
78904141
—
KY
05
—
9590108800
—
KY
Enumeration date
07/03/2006
Last updated
05/21/2013
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