Family Care Center Magnolia

Organization Active NPI Family Medicine Physician · Magnolia, KY

NPI 1194775734 · NPPES record last updated Jul 29, 2010

Key facts

NPI
1194775734
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
FAMILY CARE CENTER MAGNOLIA
Practice address
432 Mill Rd
Magnolia, KY 42757-7862
Phone
(270) 324-3241
Fax
(270) 324-3244
NPI assigned
May 12, 2006
Organization subpart
No

Authorized official

Name
Mr. Jeff D Kingery
Title
Director
Phone
(270) 706-1900

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207Q00000X Yes
Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP
363L00000X

Addresses

Primary practice location

432 Mill Rd
Magnolia, KY 42757-7862

Mailing address

PO Box 2309
Elizabethtown, KY 42702-2309
Phone (270) 706-1131

Other identifiers

IdentifierTypeStateIssuer
65935678MedicaidKY
DA0342OtherKYMEDICARE RAILROAD

Other providers in Magnolia, KY

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

Sources for this page

Verify at the official NPI Registry.