Organization · Type 2 NPI
Jellico Community Hospital, Inc
Multi-Specialty Clinic/Center · Willaimsburg, KY
NPI number
1407154800
Active
Practice location
998 South Highway 25W
Willaimsburg, KY 40769
Fax (606) 549-8107
Mailing address
188 Hospital Lane
Jellico, TN 37762-4433
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Multi-Specialty Clinic/Center Primary | 261QM1300X | None listed |
| Medical Physician Assistant | 363AM0700X | PA071 (KY) |
| Nurse Practitioner | 363L00000X | 3007739 (KY) |
| Nurse Practitioner | 363L00000X | 3004431 (KY) |
| Nurse Practitioner | 363L00000X | 3002560 (KY) |
Multi-Specialty Clinic/Center: Definition to come...
About NPI 1407154800
Jellico Community Hospital, Inc's National Provider Identifier is 1407154800, issued on Mar 9, 2011. The primary taxonomy on file is Multi-Specialty Clinic/Center (261QM1300X), and the practice location is in Willaimsburg, KY. The record was last updated on Mar 10, 2016.