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ICC MEDICAL LLC NPI 1891725743


NPI Information

NPI: 1891725743
Provider Name: ICC MEDICAL LLC

Doing Business As: IMMEDIATE CARE CLINIC

Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
405 S. L. ROGERS WELLS BLVD
GLASGOW, KY
ZIP 42141
Phone: (270) 834-8892
Get Directions

ICC MEDICAL LLC is a family medicine in Glasgow, KY. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. ICC MEDICAL LLC NPI is 1891725743. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Immediate Care Clinic.

The provider's business location address is:

405 S. L. ROGERS WELLS BLVD
GLASGOW, KY
ZIP 42141
Phone: (270) 834-8892
Fax: (270) 834-8899

The provider's authorized official is Roger Todd Williams .
The authorized official title is Owner and has the following contact phone number (270) 834-8892.

The enumeration date for this NPI number is 7/4/2006 and was last updated on 4/20/2008.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
100172MEDICARE PINKENTUCKY
2000000486204OTHERKENTUCKYANTHEM BC/BS
3=========OTHERKENTUCKYTAX ID
465945404MEDICAIDKENTUCKY

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: 11/14/2023

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