| Egan Clinic Psc | |
|
12945 W Highway 42 Prospect KY 40059-9107 | |
| (502) 228-7530 | |
| (502) 228-7533 |
| Full Name | Egan Clinic Psc |
|---|---|
| Speciality | Internal Medicine |
| Location | 12945 W Highway 42, Prospect, Kentucky |
| Authorized Official Name and Position | Lynn O Egan (PRESIDENT) |
| Authorized Official Contact | 5022287530 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Egan Clinic Psc 12945 W Highway 42 Prospect KY 40059-9107 Ph: (502) 228-7530 | Egan Clinic Psc 12945 W Highway 42 Prospect KY 40059-9107 Ph: (502) 228-7530 |
| NPI Number | 1700150109 |
|---|---|
| Provider Enumeration Date | 03/02/2012 |
| Last Update Date | 07/24/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700150109 | NPI | - | NPPES |
| 7100195370 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 39726 (Kentucky) | Primary |
| 363A00000X | Physician Assistant | (* (Not Available)) | Secondary |
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