Provider Demographics
NPI:1104151943
Name:FAMILY MEDICINE ASSOCIATES OF FRANKFORT PLLC
Entity type:Organization
Organization Name:FAMILY MEDICINE ASSOCIATES OF FRANKFORT PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAIME
Authorized Official - Middle Name:
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-352-2360
Mailing Address - Street 1:111 WESTRIDGE DR
Mailing Address - Street 2:SUITE F
Mailing Address - City:FRANKFORT
Mailing Address - State:KY
Mailing Address - Zip Code:40601-4448
Mailing Address - Country:US
Mailing Address - Phone:502-352-2360
Mailing Address - Fax:502-352-2363
Practice Address - Street 1:111 WESTRIDGE DR
Practice Address - Street 2:SUITE F
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40601-4448
Practice Address - Country:US
Practice Address - Phone:502-352-2360
Practice Address - Fax:502-352-2363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-13
Last Update Date:2009-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY41467207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty