Provider Demographics
NPI:1891717997
Name:J&D MEDICAL SERVICES PLLC
Entity type:Organization
Organization Name:J&D MEDICAL SERVICES PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:B
Authorized Official - Last Name:NOBLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:606-208-8077
Mailing Address - Street 1:PO BOX 1279
Mailing Address - Street 2:
Mailing Address - City:BEATTYVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41311-1279
Mailing Address - Country:US
Mailing Address - Phone:606-208-8077
Mailing Address - Fax:
Practice Address - Street 1:1025 GRAND AVE
Practice Address - Street 2:
Practice Address - City:BEATTYVILLE
Practice Address - State:KY
Practice Address - Zip Code:41311-1279
Practice Address - Country:US
Practice Address - Phone:606-208-8077
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2018-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY24635207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYC66978Medicare UPIN
KY183946Medicare ID - Type UnspecifiedRURAL HEALTH CLINIC