Individual
MISS CASEY LYNN DOTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
20 MEDICAL VILLAGE DR # 254, EDGEWOOD, KY 41017
(859) 344-1600
(859) 344-0091
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(859) 344-1600
(598) 344-0091
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1038
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100024070
—
KY
01
—
P00438474
MEDICARE RAILROAD
KY
Enumeration date
05/17/2007
Last updated
09/20/2019
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