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Contact Information

WESTLAKE PRIMARY CARE OF RUSSELL COUNTY MEDICAL GROUP
2465 LAKEWAY DRIVE
RUSSELL SPRINGS, KY42642
 Phone: 270-858-3636
 Fax: 270-858-3660
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Diagnostic Radiology

2085R0202X 30 Physician/Diagnostic Radiology
Indicates primary specialty

NPI Profile & details for WESTLAKE PRIMARY CARE OF RUSSELL COUNTY MEDICAL GROUP · (Female)

NPI # 1023280518
Status Active
Credentials
Entity Individual
Enumeration date 03/25/2008
Last updated 03/25/2008 - About 18 years ago
Sole proprietor 1 Not specified
Identifiers
  • KY License # 28235
  • KY Medicaid 6592976200
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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