Provider Demographics
NPI:1063645158
Name:ER & ASSOCIATES
Entity Type:Organization
Organization Name:ER & ASSOCIATES
Other - Org Name:SOUTHERN KY MEDICAL ASSOCIATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CUNDIFF-ROY
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:270-507-6088
Mailing Address - Street 1:PO BOX 1383
Mailing Address - Street 2:
Mailing Address - City:RUSSELL SPRINGS
Mailing Address - State:KY
Mailing Address - Zip Code:42642-1383
Mailing Address - Country:US
Mailing Address - Phone:270-866-4357
Mailing Address - Fax:
Practice Address - Street 1:80 JOE T PETTEY DRIVE
Practice Address - Street 2:
Practice Address - City:RUSSELL SPRINGS
Practice Address - State:KY
Practice Address - Zip Code:42642-1383
Practice Address - Country:US
Practice Address - Phone:270-866-4357
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ER & ASSOCIATES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-08-24
Last Update Date:2009-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty