Provider Demographics
NPI:1225161441
Name:HEALTH WORKS
Entity Type:Organization
Organization Name:HEALTH WORKS
Other - Org Name:CAPITAL MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:FUQUA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-223-0231
Mailing Address - Street 1:PO BOX 4168
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:KY
Mailing Address - Zip Code:40604-4168
Mailing Address - Country:US
Mailing Address - Phone:502-223-5811
Mailing Address - Fax:502-223-7379
Practice Address - Street 1:4 H M B CIRCLE
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40601-9799
Practice Address - Country:US
Practice Address - Phone:502-695-9990
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2008-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY4048Medicare PIN
KY4919Medicare PIN
KY4047Medicare PIN
KY4046Medicare PIN