Lily Creek Medical Group, Psc
NPI #1205987542 in Russell Springs, Kentucky
Provider Information
- NPI Number
- 1205987542
- Entity Type
- Organization
- Organization Name
- Lily Creek Medical Group, Psc
- Primary Specialty
- Internal Medicine
- Enumeration Date
- Jan 15, 2007
- Last Updated
- Oct 30, 2008
Practice Location
- Address
- 92 JOE T PETTY DR
- City
- Russell Springs
- State
- Kentucky
- ZIP Code
- 42642-8543
- Phone
- (270) 866-8881
Authorized Official
- Name
- ROBERT L. BERTRAM, D.O.
- Title
- PRESIDENT
- Phone
- (270) 866-8881
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner - Family — Family |
| Nurse Practitioner |
| Internal Medicine |
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