Clark, Casey Lane

Clark, Casey Lane is an individual health care provider with primary practice located at 1850 Bypass Rd , Winchester KY 40391-2300. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Clark, Casey Lane can be contacted via phone (859) 744-5111.

Contact Information

Primary practice address
1850 Bypass Rd Winchester KY 40391-2300
Phone: (859) 744-5111
Fax: (859) 744-1177
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 56386 Kentucky
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 56386 Kentucky

Profile Details

NPI number 1306340286
LBN Legal business name Clark, Casey Lane
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 23rd, 2018
Last updated May 11th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306340286 NPPES
Kentucky MEDICAID 7100615740

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