Provider Demographics
NPI:1780177618
Name:ACCESS MED, PLLC
Entity type:Organization
Organization Name:ACCESS MED, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN ASSISTANT, CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:WILLIFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-227-0828
Mailing Address - Street 1:535 WELLINGTON WAY STE 330
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-1331
Mailing Address - Country:US
Mailing Address - Phone:859-439-0400
Mailing Address - Fax:859-439-0399
Practice Address - Street 1:642 E LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:KY
Practice Address - Zip Code:40422-1719
Practice Address - Country:US
Practice Address - Phone:859-209-2269
Practice Address - Fax:859-209-2396
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-14
Last Update Date:2018-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care