Bluegrass Family Walk-in Clinic LLC

Organization Active NPI Family Medicine Physician · Pikeville, KY

NPI 1124596341 · NPPES record last updated Nov 6, 2018

Key facts

NPI
1124596341
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
BLUEGRASS FAMILY WALK-IN CLINIC LLC
Practice address
140 Adams LN Ste 600-700
Pikeville, KY 41501-3087
Phone
(606) 509-2000
NPI assigned
Nov 6, 2018
Organization subpart
No

Authorized official

Name
Dr. Chadward Lee Thacker, MD
Title
Owner
Phone
(606) 509-2000

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207Q00000X Yes

Addresses

Primary practice location

140 Adams LN Ste 600-700
Pikeville, KY 41501-3087

Mailing address

PO Box 1228
Pikeville, KY 41502-1228
Phone (606) 509-2000

Other providers in Pikeville, KY

All providers in Pikeville, KY · Family Medicine Physician in Kentucky

Sources for this page

Verify at the official NPI Registry.