Individual
GLEN CHANEY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2605 KENTUCKY AVE, PADUCAH, KY 42003-3800
(270) 744-9600
Mailing address
2605 KENTUCKY AVE, PADUCAH, KY 42003-3800
(270) 744-9600
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
18107
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64181076
—
KY
Enumeration date
09/20/2005
Last updated
07/08/2007
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