Provider Demographics
NPI:1386614188
Name:PARTIN, GARY L (MD)
Entity type:Individual
Prefix:
First Name:GARY
Middle Name:L
Last Name:PARTIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:310 INDUSTRIAL PARK RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:42743-1429
Mailing Address - Country:US
Mailing Address - Phone:270-932-2286
Mailing Address - Fax:270-932-2265
Practice Address - Street 1:310 INDUSTRIAL PARK RD
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:KY
Practice Address - Zip Code:42743-1429
Practice Address - Country:US
Practice Address - Phone:270-932-2286
Practice Address - Fax:270-932-2265
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2024-07-22
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Provider Licenses
StateLicense IDTaxonomies
KY25263207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY642526380Medicaid
KY642526380Medicaid