Pine Mountain Emergency Group Limited Liability Company

NPI #1568010064 in Harlan, Kentucky

Provider Information

NPI Number: 1568010064
Entity Type: Organization
Organization Name: Pine Mountain Emergency Group Limited Liability Company
Primary Specialty: Emergency Medicine
Enumeration Date: Aug 28, 2019
Last Updated: Mar 23, 2022

Practice Location

Address: 81 BALL PARK RD
City: Harlan
State: Kentucky
ZIP Code: 40831-1701
Phone: (606) 573-8100

Authorized Official

Name: LISHA C FALK
Title: VP OF CONTRACTING
Phone: (337) 609-1221

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X
Nurse Practitioner	363L00000X
Emergency Medicine	207P00000X	Primary

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