Individual
DR. CLARK COSTIGAN LESTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 TRILLIUM WAY, CORBIN, KY 40701-8727
(606) 523-1934
Mailing address
245 FOUNTAIN CT, LEXINGTON, KY 40509-1200
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
46500
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100250980
—
KY
01
—
P01458488
RAILROAD MEDICARE
KY
Enumeration date
05/11/2009
Last updated
09/30/2016
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