Organization
KENTUCKY PRIMARY MEDICAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PHILLIP RANDY MULLINS (CEO)
(606) 487-0776
Entity
Organization
Contact information
Practice address
311 ROY CAMPBELL DR, HAZARD, KY 41701-9486
(606) 487-0776
(606) 487-0777
Mailing address
PO BOX 1797, HAZARD, KY 41702-1797
(606) 487-0776
(606) 487-0777
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
07/02/2012
Last updated
02/10/2014
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