# LARA R CLARY LANTIS DO PSC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** BELLEFONTE FAMILY MEDICINE
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548459118
- **Authorized official:** MARY L CAUDILL (OFFICE MANAGER)
- **Authorized official phone:** (606) 836-0165

## Contact information

- **Practice address:** 903 BELLEFONTE RD, SUITE B, FLATWOODS, KY 41139-2005
- **Practice address phone:** (606) 836-0165
- **Mailing address:** 903 BELLEFONTE RD, SUITE B, FLATWOODS, KY 41139-2005
- **Mailing address phone:** (606) 836-0165

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 02851 | KY | Yes |

## Other

- **Enumeration date:** 10/19/2007
- **Last updated:** 10/25/2007