Individual
BETHANY MCCLURE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2300 KY 801 NORTH, MOREHEAD, KY 40351
(606) 548-5550
Mailing address
316 W 2ND ST, MOREHEAD, KY 40351-1550
(606) 784-3771
(606) 783-6847
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1694
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100188980
—
KY
01
—
K370051
MEDICARE
KY
01
—
PA1694
KY PA LICENSE
KY
Enumeration date
12/14/2011
Last updated
07/11/2023
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