| Organization Name: | KENTUCKYONE HEALTH MEDICAL GROUP, INC. |
| NPI Number: | 1144633405 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RUTH W BRINKLEY (CEO) |
| Mailing Address: | 44 Water St Owingsville |
| State: | KY US |
| Postal Code: | 403608944 |
| Phone Number: | 6066749776 |
| Fax Number: | |
| NPI Enumeration Date: | 06/04/2014 |
| NPI Last Update Date: | 06/04/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR1300X |
| License Number: | 900170 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KY |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rural Health |
| Taxonomy Definition: | |