Main Street Family Medicine, LLC

NPI #1528097433 in Whitesville, Kentucky

Provider Information

NPI Number: 1528097433
Entity Type: Organization
Organization Name: Main Street Family Medicine, LLC
Primary Specialty: Physician Assistant
Enumeration Date: Jul 2, 2006
Last Updated: Mar 21, 2022

Practice Location

Address: 10015 MAIN ST
City: Whitesville
State: Kentucky
ZIP Code: 42378-9557
Phone: (270) 233-1884

Authorized Official

Name: CYNTHIA DIANNE GLENN-BIRKHEAD, ARNP
Title: OWNER
Phone: (270) 233-1884

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary
Nurse Practitioner - Family — Family	363LF0000X

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