Graduated: 2012
NPI: 1720337967
Practice Locations (3)
KENTUCKY MSO LLC
105 PRATHER PATH
GEORGETOWN, KY 403249206
KENTUCKY MSO LLC
175 HOSPITAL DR, SUITE 120
GEORGETOWN, KY 40324
5025702324
CLARK REGIONAL PHYSICIAN PRACTICES LLC
129 STONE TRACE DR
MT STERLING, KY 403539386
8594986006
Source: CMS National Downloadable File, September 2026.