Unknown Individual – Family Medicine Physician, NPI 1457322349
Family Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
2300 CHAMBER CENTER DR
SUITE 200
LAKESIDE PARK, KY 410171673
Phone: (859) 344-5555
Fax: (859) 344-5552
Type: Mailing
79, Country Club Drive, Butler, Choctaw County, Alabama, 36904, United States
BUTLER, KY 410068704
Phone: (859) 654-2283
Fax: (859) 654-2284
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 41017)
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