Organization
JACKSON PURCHASE PULMONARY MEDICINE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TAMMY D MCCARY (OFFICE MANAGER)
(270) 251-4040
Entity
Organization
Contact information
Practice address
1111 MEDICAL CENTER CIR, MAYFIELD, KY 42066-1194
(270) 251-4040
(855) 430-0335
Mailing address
1111 MEDICAL CENTER CIR, MAYFIELD, KY 42066-1194
(270) 251-4040
(855) 430-0335
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3010022
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100399120
—
KY
Enumeration date
09/27/2016
Last updated
09/27/2016
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