OrganizationActive
St. John Neumann'S Extended Hours Clinic
NPI 1003004912 · Family Medicine Physician · Jackson, KY
Provider details
- NPI number
- 1003004912
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Authorized official
- Theresa Merced, Office Manager
- License
- KY24420 (KY)
Practice location
1389 Highway 15 North
Jackson, KY 41339
Phone: (606) 666-4011
Fax: (606) 666-5801
Mailing address
Po Box 606
Jackson, KY 41339-0606
Registry dates
- Enumerated
- 2007-10-05
- Last updated
- 2007-10-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.