| NPI Details | |
|---|---|
| NPI | 1053305524 |
| Enumeration Date | 09/09/2005 |
| Last Updated | 09/06/2013 |
| Entity Type | Healthcare Provider |
| Active | Over 12 years ago |
| Authorized Information | |
|---|---|
| Name | MARY JO MARY JO |
| Position | ADMINISTRATOR |
| Phone | (502) 350-0050 |
| Fax | (502) 348-6505 |
| Practice Location | |
|---|---|
| 201 S 5TH ST BARDSTOWN KY, 40004-1142, US |
|
| Phone | (502) 350-0050 |
| Fax | (502) 348-6505 |
| Business Location | |
|---|---|
| 201 S 5TH ST BARDSTOWN KY, 40004-1142, US |
|
| Phone | (502) 350-0050 |
| Fax | (502) 348-6505 |
| Toxanomy | |
|---|---|
| Taxonomy Code | 363L00000X |
| License State | |
| License Number | |
| Remove 1053305524 NPI Number | |
According to our database, Bardstown Primary Care, Pllc NPI is 1053305524, taxonomy code is 363L00000X Bardstown Primary Care, Pllc physically located at 201 S 5th St, Bardstown KY, 40004-1142. NPI Number 1033115704 has the healthcare provider type.
Sponsored links
1053305524 NPI number is provided on an as is basis without warranty of any kind. 1053305524 is maintained by the National Plan & Provider Enumeration System. The contents of Bardstown Primary Care, Pllc are for informational purposes only.
Sponsored links