1922006568 NPI number — MICHAEL W VORIES MD

Table of content: (NPI 1922006568)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922006568 NPI number — MICHAEL W VORIES MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MICHAEL W VORIES MD
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1922006568
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/11/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1297
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HAZARD
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
41702
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
606-487-0776
Provider Business Mailing Address Fax Number:
606-487-0777

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
311 ROY CAMPBELL DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HAZARD
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-487-0776
Provider Business Practice Location Address Fax Number:
606-487-0777
Provider Enumeration Date:
07/08/2005

Additional Information

Authorized Official

Authorized Official Last Name:
MULLINS
Authorized Official First Name:
PHILLIP
Authorized Official Middle Name:
R
Authorized Official Title or Position:
COO
Authorized Official Telephone Number:
606-487-0776

Provider Taxonomy Codes

  • Taxonomy code: 208VP0000X , with the licence number:  29445 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 78903515 . This is a "MEDICAID NURSE PRAC. GRP" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 65938417 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000203254 . This is a "ANTHEM BCBS" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".




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