Individual
LUCAS TAYLOR EDELEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
109 DANIEL DRIVE, DANVILLE, KY 40422-3543
(859) 236-3361
Mailing address
109 DANIEL DRIVE, DANVILLE, KY 40422
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
58308
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/18/2018
Last updated
06/26/2023
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