Charles McMillian
Individual provider Active NPI Community Health Worker · Tompkinsville, KY
NPI 1053728709 · NPPES record last updated Jul 15, 2014
Key facts
- NPI
- 1053728709
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Community Health Worker 172V00000X
- Practice address
- 800 N Main St
Tompkinsville, KY 42167-1037 - Phone
- (270) 901-5000
- Fax
- (270) 842-5268
- NPI assigned
- Jul 15, 2014
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | Yes |
Addresses
Primary practice location
800 N Main St
Tompkinsville, KY 42167-1037
Mailing address
800 N Main St
Tompkinsville, KY 42167-1037
Phone (270) 901-5000
Other providers in Tompkinsville, KY
- Living Well Healthcare, LLC
- LP Tompkinsville, LLC
- Andrea Moore McAlpin
- Laura McCarty
- Lindsay McCoy
- Justin McMillian
- Caylan McPherson
- Shaun Brantley McPherson
- Med-Coe Inc
- Medical Adrenaline, LLC
All providers in Tompkinsville, KY · Community Health Worker in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 15, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.