Individual
MARK RICHARD SECOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
191A GLADES RD., BEREA, KY 40403-1742
(859) 986-1679
(859) 986-1040
Mailing address
191A GLADES RD., BEREA, KY 40403-1742
(859) 986-1679
(859) 986-1040
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
23629
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000068790
ANTHEM
—
01
—
4612084
AETNA
—
05
—
64236292
—
KY
Enumeration date
07/26/2006
Last updated
07/08/2007
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