Organization
MESA MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEREMY PATRICK STICH M.D. (EMERGENCY PHYSICIAN)
(859) 330-4473
Entity
Organization
Contact information
Practice address
660 IRVIN RD, DANVILLE, KY 40422-8897
(859) 333-3065
Mailing address
1792 ALYSHEBA WAY, LEXINGTON, KY 40509-2288
(859) 335-9041
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
44491
KY
Other
Enumeration date
09/09/2008
Last updated
07/02/2013
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