Provider Demographics
NPI:1023280674
Name:JEFFREY L. RINEY M.D. & ASSOCIATES PLLC
Entity type:Organization
Organization Name:JEFFREY L. RINEY M.D. & ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:L
Authorized Official - Last Name:RINEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:270-441-4610
Mailing Address - Street 1:225 MEDICAL CENTER DR
Mailing Address - Street 2:SUITE 209B
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42003-7914
Mailing Address - Country:US
Mailing Address - Phone:270-441-4610
Mailing Address - Fax:270-441-4608
Practice Address - Street 1:225 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 209B
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42003-7914
Practice Address - Country:US
Practice Address - Phone:270-441-4610
Practice Address - Fax:270-441-4608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-24
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY207Q00000X207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY30441OtherMEDICAL LICENSE
KY64304413Medicaid
KYG39461OtherUPIN
KY111458OtherBCBS
KY111458OtherBCBS
KY64304413Medicaid