Beaver Creek Emergency Group LLC

NPI #1689165904 in Martin, Kentucky

Provider Information

NPI Number: 1689165904
Entity Type: Organization
Organization Name: Beaver Creek Emergency Group LLC
Primary Specialty: Emergency Medicine
Enumeration Date: May 22, 2018
Last Updated: Mar 23, 2022

Practice Location

Address: 11203 MAIN ST
City: Martin
State: Kentucky
ZIP Code: 41649-7999
Phone: (606) 285-6490

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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