Provider Demographics
NPI:1801900659
Name:REGIONAL PHYSICIANS CORPORATION II
Entity type:Organization
Organization Name:REGIONAL PHYSICIANS CORPORATION II
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:DONALD
Authorized Official - Last Name:FRARACCIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-745-3500
Mailing Address - Street 1:1115 MCCANN DR
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:KY
Mailing Address - Zip Code:40391-1158
Mailing Address - Country:US
Mailing Address - Phone:859-745-6471
Mailing Address - Fax:859-744-0257
Practice Address - Street 1:1115 MCCANN DRIVE
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40391-4140
Practice Address - Country:US
Practice Address - Phone:859-745-6471
Practice Address - Fax:859-744-0257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY65943003Medicaid
KY9566Medicare PIN