Crab Orchard Family Practice Clinic
Organization Active NPI Family Medicine Physician · Crab Orchard, KY
NPI 1801848460 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1801848460
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 900152 (KY)
- Legal business name
- CRAB ORCHARD FAMILY PRACTICE CLINIC
- Practice address
- 207 Main St
Crab Orchard, KY 40419-9697 - Phone
- (606) 355-7300
- Fax
- (606) 355-7310
- NPI assigned
- May 16, 2006
- Organization subpart
- No
Authorized official
- Name
- Robert A. Carter Jr.
- Title
- President
- Phone
- (606) 528-0283
Corporate family (same tax ID) 1
Practitioners 11
-
Joyce Ann Allen, APRN-FNP
-
Sheila D Fisher, ARNP
-
Vicki L. Hisle, MSN, FNP-BC
-
Maher Kassis, M.D.
-
Jackie C. Noland, ARNP
-
Mehdi Poorkay, M.D.
-
Cynthia J Simpson, ARNP
-
Eric Lopez Martino, M.D.
-
Neelkamal Soares, M.D.
National Provider Directory
- Tax ID family
- Crab Orchard Family Practice Clinic
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | 900152 | KY | Yes |
Addresses
Primary practice location
207 Main St
Crab Orchard, KY 40419-9697
Mailing address
PO Box 1125
Corbin, KY 40702-1125
Phone (606) 528-0283
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 35001502 | Medicaid | KY |
Other providers in Crab Orchard, KY
- Heather Jones Adams
- Tammy Lee Baker
- Ashlyn E Boots
- Mattie A Byler
- Crab Orchard Family Practice Clinic, Inc.
- Cumberland Family Medical Center Inc
- East End Ambulance Service Inc
- Jessica D Fletcher
- Lincoln County Health Department
All providers in Crab Orchard, 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.