Provider Demographics
NPI:1750790069
Name:EPHRAIM MCDOWELL HEALTH RESOURCE, INC
Entity type:Organization
Organization Name:EPHRAIM MCDOWELL HEALTH RESOURCE, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKAY
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:859-239-2409
Mailing Address - Street 1:125 PORTMAN AVE
Mailing Address - Street 2:
Mailing Address - City:STANFORD
Mailing Address - State:KY
Mailing Address - Zip Code:40484-1229
Mailing Address - Country:US
Mailing Address - Phone:606-365-3378
Mailing Address - Fax:606-365-3381
Practice Address - Street 1:125 PORTMAN AVE
Practice Address - Street 2:
Practice Address - City:STANFORD
Practice Address - State:KY
Practice Address - Zip Code:40484-1229
Practice Address - Country:US
Practice Address - Phone:606-365-3378
Practice Address - Fax:606-365-3381
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-12
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & GynecologyGroup - Single Specialty