institution
My 3 C's Enterprises, Pllc
General Practice Physician in Edmonton, Kentucky
NPI 1902027865

My 3 C's Enterprises, Pllc is a General Practice Physician based in Edmonton, KY. My 3 C's Enterprises, Pllc practices in Edmonton, KY. The NPI Number for My 3 C's Enterprises, Pllc is 1902027865 and holds a License No. 35818 (Kentucky).

The current practice location address for My 3 C's Enterprises, Pllc is 1704 W Stockton St, Edmonton, KY and can be reached out via phone at 270-432-4800 and via fax at 270-432-4804.

Location: 1704 W Stockton St, Edmonton, KY, 42129-8137
institution
Provider Profile Details
NPI Number
1902027865
Provider Name
My 3 C's Enterprises, Pllc
Credential
Provider Entity Type
Organization
Address
1704 W Stockton St, Edmonton, KY, 42129-8137
Phone Number
270-432-4800
Fax Number
270-432-4804
Provider Enumeration Date
05/01/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
000000259528 01 KY BLUE CROSS
64029440 05 KY
000000259528 01 KY ANTHEM
institution
Provider Business Practice Location Address Details
Address
1704 W Stockton St
City
State
Zip
42129-8137
Phone Number
270-432-4800
Fax Number
270-432-4804
person
Provider Business Mailing Address Details
Address
1704 W Stockton St
City
State
Zip
42129-8137
Phone Number
270-432-4800
Fax Number
270-432-4804
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
License No.
35818 (Kentucky)
Definition
Definition to come...
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