Southern Kentucky Medical Associates, Psc

NPI #1821392515 in Russell Springs, Kentucky

Provider Information

NPI Number: 1821392515
Entity Type: Organization
Organization Name: Southern Kentucky Medical Associates, Psc
Primary Specialty: General Practice
Enumeration Date: Jan 10, 2011
Last Updated: Feb 14, 2011

Practice Location

Address: 72 JOE T. PETTEY DR
City: Russell Springs
State: Kentucky
ZIP Code: 42642
Phone: (270) 866-4357

Authorized Official

Name: ANGELA CUNDIFF-ROY
Title: PRESIDENT
Phone: (270) 866-4357

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Nurse Practitioner - Adult Health — Adult Health	363LA2200X
General Practice	208D00000X	Primary

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