Knox County Family Practice Clinic
Organization Active NPI Family Medicine Physician · Gray, KY
NPI 1366494080 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1366494080
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 900118 (KY)
- Legal business name
- KNOX COUNTY FAMILY PRACTICE CLINIC
- Practice address
- 39 Cumberland Gap PLZ
Gray, KY 40734-4536 - Phone
- (606) 528-2850
- Fax
- (606) 528-1131
- NPI assigned
- May 17, 2006
- Organization subpart
- No
Authorized official
- Name
- Robert A. Carter Jr.
- Title
- President
- Phone
- (606) 528-0283
National Provider Directory
Locations
39 Cumberland Gap Plz
#1
Gray, KY 40734
Phone (606) 528-2850
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | 900118 | KY | Yes |
Addresses
Primary practice location
39 Cumberland Gap PLZ
Gray, KY 40734-4536
Mailing address
PO Box 1125
Corbin, KY 40702-1125
Phone (606) 528-0283
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 35001163 | Medicaid | KY |
Other providers in Gray, KY
- Melissa Garland
- Natasha Garrison
- Rita Carol Gilbert
- Kristy Marie Keefe
- Kentucky Rural Health Information Technology Network, Inc.
- Knox County Family Practice Clinic, Inc.
- Bianca Lambert
- Mary Beth Lopez
- Janet Y Mosley
- Redemption Road Recovery
All providers in Gray, KY · Family Medicine Physician in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. 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.