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BAPTIST PHYSICIANS SOUTHEAST, INC.

Ambulatory Health Care Facilities Clinic/Center Primary Care

Provider NPI: 1407044217

Organization Information:
Organization Name:  BAPTIST PHYSICIANS SOUTHEAST, INC.
Organization is not Subpart
Authorized Official:  LARRY  GRAY  PRESIDENT/CEO  606-526-8131

Practice Location:
1 TRILLIUM WAY  CORBIN, KY 40701-8426 US
Tel: 606-526-8131  Fax: 606-528-8661

Business Mailing Address:
PO BOX 1325  CORBIN, KY 40702-1325 US
Tel: 606-526-8131  Fax: 606-528-8661

NPI Information:
NPI: 1407044217
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N261QP2300XAmbulatory Health Care Facilities
Clinic/Center
Primary Care
KY700214
N363L00000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
KY5263P
N207RG0100XPhysicians
Internal Medicine
N207RH0003XPhysicians
Internal Medicine
N207RP1001XPhysicians
Internal Medicine
N207R00000XPhysicians
Internal Medicine
N207RC0000XPhysicians
Internal Medicine
N1041C0700XBehavioral Health & Social Service Providers
Social Worker
N363A00000XPhysician Assistants & Advanced Practice Nursing Providers
Physician Assistant
KY
N2085R0202XPhysicians
Radiology
Y207Q00000XPhysicians
Family Medicine
N208800000XPhysicians
Urology
N261QR1300XAmbulatory Health Care Facilities
Clinic/Center
KY900027
N207X00000XPhysicians
Orthopaedic Surgery
N208600000XPhysicians
Surgery

Other Provider Identifiers:

IssuerNumberStateType
MEDICAID PHYSICIAN ASSISTANTS7100221220KY01
MEDICAID LCSW7100302310KY01
MEDICAID NURSE PRACTITIONERS7100097590KY01
7100027820KY05



American Medical Association 2012 taxonomy code information

Code: 207Q00000X

Type:

Classification:



Definition:



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