NPI 1003004912

St. John Neumann's Extended Hours Clinic

Organisation Family Medicine Physician Jackson, KY

Practice location

Address: 1389 Highway 15 North, Jackson, KY 41339
Phone: (606) 666-4011
Fax: (606) 666-5801
Mailing address: PO Box 606, Jackson, KY 41339-0606

Authorised official

Name: Theresa Merced
Title: Office Manager
Phone: (606) 666-4011

Registered specialties

Family Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207Q00000X Licence KY24420 (KY)

Other Family Medicine providers in Kentucky →

Registry record

NPI: 1003004912
Entity type: Organization
NPI issued: 5 Oct 2007
Record last updated: 5 Oct 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.