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Contact Information

BLUEGRASS CLINIC STANFORD, PLLC
107 METKER TRL
SUITE A
STANFORD, KY40484-1049
 Phone: 606-365-8338
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Legal Medicine

173000000X
Indicates primary specialty

NPI Profile & details for BLUEGRASS CLINIC STANFORD, PLLC

NPI # 1265571020
LBN Legal business name BLUEGRASS CLINIC STANFORD, PLLC
Authorized official JAMES MILLER - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 02/06/2007
Last updated 10/04/2023 - About 3 years ago
Identifiers
KY License # 30199
KY Medicaid 35001882
KY Other DE0433 RR MEDICARE GROUP NUMBER
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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