FAMILY PRACTICE CLINIC OF BOONEVILLE, INC.


Address: 200 Mulberry St, Suite A, Booneville, KY 41314-7505
Phone: 6065936023

FAMILY PRACTICE CLINIC OF BOONEVILLE, INC. (NPI# 1326152109) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1326152109
Entity Type Organization
Organization Name FAMILY PRACTICE CLINIC OF BOONEVILLE, INC.
Practice Address 200 Mulberry St
Suite A
Booneville
KY 41314-7505
Mailing Address Po Box 737
200 Mulberry Street, Suite A
Booneville
KY 41314-0737
Practice Telephone 6065936023
Practice Fax Number 6065936087
Mailing Telephone 6065936023
Mailing Fax Number 6065936087
Enumeration Date 2006-08-18
Last Update Date 2015-12-22
Authorized Official Name KIM COX (OWNER OPERATOR)
Authorized Official Telephone 6065936023
Authorized Official Credential APRN
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207Q00000X Family Medicine Allopathic & Osteopathic Physicians
Y 261QR1300X Clinic/Center
Specialization: Rural Health
Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
KY 7100159610 05

Office Location

Street Address 200 MULBERRY ST
SUITE A
City BOONEVILLE
State KY
Zip Code 41314-7505

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Taxonomy Information

Taxonomy Code 261QR1300X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Rural Health

Taxonomy Definition

Definition to come...

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Competitor

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City BOONEVILLE
Zip Code 41314

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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