WESTERN BAPTIST MEDICAL VENTURES INC NPI 1093063406

NPI Information

NPI: 1093063406
Provider Name: WESTERN BAPTIST MEDICAL VENTURES INC

Doing Business As: BAPTIST HEALTH PRIME CARE CENTER

Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
2601 KENTUCKY AVE
SUITE 103
PADUCAH, KY
ZIP 42003
Phone: (270) 443-4311
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WESTERN BAPTIST MEDICAL VENTURES INC is a primary care clinic center in Paducah, KY. WESTERN BAPTIST MEDICAL VENTURES INC NPI is 1093063406. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Baptist Health Prime Care Center.

The provider's business location address is:

2601 KENTUCKY AVE
SUITE 103
PADUCAH, KY
ZIP 42003-817
Phone: (270) 443-4311
Fax: (270) 443-4145

The provider's authorized official is Patricia Harrod .
The authorized official title is Director Of Physician Integration and has the following contact phone number (270) 575-8362.

The enumeration date for this NPI number is 8/16/2012 and was last updated on 10/12/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine			KENTUCKY	No
2	363LF0000X	Nurse Practitioner	Family			No
3	363AM0700X	Physician Assistant	Medical	PA588	KENTUCKY	No
4	261QP2300X	Clinic/Center	Primary Care		KENTUCKY	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00211	MEDICARE PIN	KENTUCKY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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