Provider Demographics
NPI:1770891483
Name:CAPITAL FAMILY PHYSICIANS
Entity type:Organization
Organization Name:CAPITAL FAMILY PHYSICIANS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING OFFICE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:P
Authorized Official - Last Name:WHITAKER
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:502-223-5811
Mailing Address - Street 1:PO BOX 4168
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:KY
Mailing Address - Zip Code:40604-4168
Mailing Address - Country:US
Mailing Address - Phone:502-223-5811
Mailing Address - Fax:
Practice Address - Street 1:4 HMB CIR
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40601-5376
Practice Address - Country:US
Practice Address - Phone:502-223-5811
Practice Address - Fax:502-227-7379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-15
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100097350Medicaid
KY7800606100Medicaid