Provider Demographics
NPI:1659853711
Name:RURAL MEDICAL GROUP
Entity Type:Organization
Organization Name:RURAL MEDICAL GROUP
Other - Org Name:RURAL MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:APRN/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:606-874-0509
Mailing Address - Street 1:6450 KY ROUTE 1428
Mailing Address - Street 2:STE. 2
Mailing Address - City:ALLEN
Mailing Address - State:KY
Mailing Address - Zip Code:41601
Mailing Address - Country:US
Mailing Address - Phone:606-874-0509
Mailing Address - Fax:606-874-0590
Practice Address - Street 1:6450 KY ROUTE 1428 STE 2
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:KY
Practice Address - Zip Code:41601-9461
Practice Address - Country:US
Practice Address - Phone:606-874-0509
Practice Address - Fax:606-874-0590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-05
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty