MEDICAL INVESTMENT TRUST
Allergy and Immunology
Pikeville, Kentucky
Provider NPI: 1053382788
Organization Information:Organization Name: MEDICAL INVESTMENT TRUST
Practice Location:
156 ISLAND CREEK RD PIKEVILLE, KY 41501 US
Tel: 606-432-0174 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
156 ISLAND CREEK RD PIKEVILLE, KY 41501 US
Tel: 606-432-0174 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
N | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Family | KY | 3001627 |
Y | 207K00000X | Physicians Allergy & Immunology | KY | 17816 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
65-922866 | KY | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
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