Organization
KENTUCKY RIVER PHYSICIAN CORPORATION
Active
Organization
KENTUCKY RIVER PHYSICIAN CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBBIE BREWER (DIRECTOR OF PROVIDER ENROLLMENT)
(877) 892-9813
Entity
Organization
Contact information
Practice address
424 JETT DR, JACKSON, KY 41339-9621
(606) 666-6600
(606) 693-0534
Mailing address
PO BOX 689022, FRANKLIN, TN 37068-9022
(615) 465-7000
(615) 465-3007
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
04/03/2007
Last updated
03/19/2012
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