Provider Demographics
NPI:1275702540
Name:FRANK MCBRAYER, M.D. PSC
Entity Type:Organization
Organization Name:FRANK MCBRAYER, M.D. PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LUCIEN
Authorized Official - Middle Name:FRANKLIN
Authorized Official - Last Name:MCBRAYER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-623-2844
Mailing Address - Street 1:236 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-1628
Mailing Address - Country:US
Mailing Address - Phone:859-623-2844
Mailing Address - Fax:859-623-2110
Practice Address - Street 1:236 E MAIN ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-1628
Practice Address - Country:US
Practice Address - Phone:859-623-2844
Practice Address - Fax:859-623-2110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-21
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY19059261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
1174620777OtherNPI(INDIVIDUAL)
KY65934051Medicaid
C74303Medicare UPIN
KY65934051Medicaid