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Southfork Medical Clinic Pllc
Specialist in Whitley City, Kentucky
NPI 1295718757

Southfork Medical Clinic Pllc is a Specialist based in Whitley City, KY. Southfork Medical Clinic Pllc practices in Whitley City, KY. The NPI Number for Southfork Medical Clinic Pllc is 1295718757 and holds a License No. (Kentucky).

The current practice location address for Southfork Medical Clinic Pllc is 71 Medical Ln, Whitley City, KY and can be reached out via phone at 606-376-7212 and via fax at 606-376-7216.

Location: 71 Medical Ln, Whitley City, KY, 42653-4216
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1295718757
Provider Name
Southfork Medical Clinic Pllc
Credential
Provider Entity Type
Organization
Address
71 Medical Ln, Whitley City, KY, 42653-4216
Phone Number
606-376-7212
Fax Number
606-376-7216
Provider Enumeration Date
11/29/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
07396 01 KY MEDICARE B
35001593 05 KY
institution
Provider Business Practice Location Address Details
Address
71 Medical Ln
City
Whitley City
State
Kentucky
Zip
42653-4216
Phone Number
606-376-7212
Fax Number
606-376-7216
person
Provider Business Mailing Address Details
Address
71 Medical Ln
City
Whitley City
State
Kentucky
Zip
42653-4216
Phone Number
606-376-7212
Fax Number
606-376-7216
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
()
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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