Individual
MELONIE C PROCTOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1808 BRISTOW DRIVE, UNION, KY 41091-3513
(859) 301-7210
(859) 301-7216
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(859) 301-7210
(859) 301-7216
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
03181
KY
207Q00000X
Family Medicine Physician
R1572
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3110270
—
OH
05
—
7100135290
—
KY
01
—
P00856623
RAILROAD MEDICARE
KY
Enumeration date
02/17/2009
Last updated
03/09/2021
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