Provider Demographics
NPI:1275869083
Name:EASTERN KENTUCKY COMPREHENSIVE CARE, PLLC
Entity Type:Organization
Organization Name:EASTERN KENTUCKY COMPREHENSIVE CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:PARKER
Authorized Official - Last Name:CRACE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:606-886-1077
Mailing Address - Street 1:400 UNIVERSITY DR
Mailing Address - Street 2:SUITE 212
Mailing Address - City:PRESTONSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41653-1080
Mailing Address - Country:US
Mailing Address - Phone:606-886-1077
Mailing Address - Fax:606-886-1170
Practice Address - Street 1:50 PROFESSOR CLARKE CIRCLE
Practice Address - Street 2:
Practice Address - City:HINDMAN
Practice Address - State:KY
Practice Address - Zip Code:41822-0000
Practice Address - Country:US
Practice Address - Phone:606-886-8240
Practice Address - Fax:606-886-8243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-29
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health