Organization Name: | MS COMMUNITY HEALTH LLC |
NPI Number: | 1023019130 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | THOMAS RANDALL POWELL (CHIEF EXECUTIVE OFFICER) |
Mailing Address: | 1010 Medical Center Drive Powderly |
State: | KY US |
Postal Code: | 42367 |
Phone Number: | 2703771600 |
Fax Number: | 2703880229 |
NPI Enumeration Date: | 08/10/2005 |
NPI Last Update Date: | 12/18/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |