Provider Demographics
NPI:1548216054
Name:ANDERSON FAMILY HEALTH CARE, PLLC
Entity Type:Organization
Organization Name:ANDERSON FAMILY HEALTH CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D./OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:WELLING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-873-1303
Mailing Address - Street 1:360 AMSDEN AVE
Mailing Address - Street 2:
Mailing Address - City:VERSAILLES
Mailing Address - State:KY
Mailing Address - Zip Code:40383-1854
Mailing Address - Country:US
Mailing Address - Phone:859-873-1303
Mailing Address - Fax:859-873-1335
Practice Address - Street 1:360 AMSDEN AVE
Practice Address - Street 2:
Practice Address - City:VERSAILLES
Practice Address - State:KY
Practice Address - Zip Code:40383-1851
Practice Address - Country:US
Practice Address - Phone:859-873-1303
Practice Address - Fax:859-873-1335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY65935959Medicaid
KY7173Medicare ID - Type UnspecifiedMEDICARE GROUP ID #