Organization
SOUTHEAST KENTUCKY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YASSER NADIM (PRESIDENT)
(606) 679-1189
Entity
Organization
Contact information
Practice address
402 BOGLE ST, SUITE 2, SOMERSET, KY 42503-2870
(606) 679-1189
Mailing address
402 BOGLE ST, SUITE 2, SOMERSET, KY 42503-2870
(606) 679-1189
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
34018
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65933681
—
KY
Enumeration date
09/21/2006
Last updated
08/22/2020
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