OrganizationManchester Family Practice ClinicFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address2734 S Highway 421, Manchester, KY 40962-7515(606) 599-0609(606) 528-0283PECOS EnrollmentBased on the most recent information from CMS, provider Manchester Family Practice Clinic does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records today at 11:36 AM.Profile DetailsProvider ID1447201207Provider TypeOrganizationFull NameManchester Family Practice ClinicSubpartNoEnumeration Date5/15/2006Last Updated8/21/2007Contact InformationPractice LocationPractice Address2734 S Highway 421, Manchester, KY 40962-7515Phone(606) 599-0609Fax(606) 599-8419Mailing LocationMailing AddressPO Box 1125, Corbin, KY 40702-1125Phone(606) 528-0283Fax(606) 528-8422Authorized OfficialNameCarter, Robert A. (President)Phone(606) 528-0283Provider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicense900112KentuckyProvider IdentifiersIDDescriptionIssuerID35001072DescriptionMedicaidIssuerUnlistedKentucky