Provider Demographics
NPI:1205665916
Name:PATEL MEDICAL CENTER PLLC
Entity type:Organization
Organization Name:PATEL MEDICAL CENTER PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TRACIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GLASSCOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-547-7161
Mailing Address - Street 1:681 E HIGHWAY 60
Mailing Address - Street 2:
Mailing Address - City:HARDINSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40143-5802
Mailing Address - Country:US
Mailing Address - Phone:270-756-2121
Mailing Address - Fax:270-580-2199
Practice Address - Street 1:681 E HIGHWAY 60
Practice Address - Street 2:
Practice Address - City:HARDINSBURG
Practice Address - State:KY
Practice Address - Zip Code:40143-5802
Practice Address - Country:US
Practice Address - Phone:270-756-2121
Practice Address - Fax:270-580-2199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-31
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health