NPI Details | |
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NPI | 1053305524 |
Enumeration Date | 09/09/2005 |
Last Updated | 09/06/2013 |
Entity Type | Healthcare Provider |
Active | Over 12 years ago |
Authorized Information | |
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Name | MARY JO MARY JO |
Position | ADMINISTRATOR |
Phone | (502) 350-0050 |
Fax | (502) 348-6505 |
Practice Location | |
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201 S 5TH ST BARDSTOWN KY, 40004-1142, US |
|
Phone | (502) 350-0050 |
Fax | (502) 348-6505 |
Business Location | |
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201 S 5TH ST BARDSTOWN KY, 40004-1142, US |
|
Phone | (502) 350-0050 |
Fax | (502) 348-6505 |
Toxanomy | |
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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.
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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.
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