Southfork Medical Clinic Pllc

LBN: Southfork Medical Clinic Pllc
Southfork Medical Clinic Pllc is an health care organization with primary practice located at 71 Medical Ln , Whitley City KY 42653-4216. The organization recently has only one registered license in Other Service Providers / Specialist, which is considered as the primary health care specialty. Southfork Medical Clinic Pllc can be contacted via phone (606) 376-7212, or through Pimentel, Francis via phone (606) 376-7212.

Contact Information

Primary practice address
71 Medical Ln Whitley City KY 42653-4216
Phone: (606) 376-7212
Fax: (606) 376-7216
Website:
Map and Directions
Authorized official contact:
Name: Pimentel, Francis Doctor of Medicine (MD)
Phone: (606) 376-7212

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X

Profile Details

NPI number 1295718757
LBN Legal business name Southfork Medical Clinic Pllc
DBA Doing business as
Authorized official Pimentel, Francis Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Nov 29th, 2005
Last updated Aug 23rd, 2011 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295718757 NPPES
Kentucky Other 07396 MEDICARE B
Kentucky MEDICAID 35001593 MEDICARE B

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