Individual
DR. C. GLEN CLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
126 PORTMAN AVE, STANFORD, KY 40484-1230
(606) 365-9181
(606) 365-9183
Mailing address
126 PORTMAN AVE, STANFORD, KY 40484-1230
(606) 365-9181
(606) 365-9183
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
17220
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64-172208
—
KY
Enumeration date
10/04/2006
Last updated
02/05/2013
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