Organization
WESTERN KY FAMILY HEALTH CARE INC
Active
Other names
WKY FAMILY HEALTHCARE
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY ALAN CARRICO MD (OWNER)
(270) 251-3223
Entity
Organization
Contact information
Practice address
318 S 7TH ST, MAYFIELD, KY 42066-2337
(270) 251-3223
(270) 251-3220
Mailing address
318 S 7TH ST, MAYFIELD, KY 42066-2337
(270) 251-3223
(270) 251-3220
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18D1098184
CLIA WAVE
KY
01
—
7100083510
MEDICAID GRP -PHY
KY
01
—
7100090880
MEDICAID GRP -ARNP
KY
Enumeration date
03/23/2009
Last updated
09/17/2024
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