Individual
DR. JOSEPH ALVIN CLAN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5211 COMMERCE CROSSINGS DR, LOUISVILLE, KY 40229-2183
(502) 966-3918
(502) 969-3665
Mailing address
PO BOX 776879, CHICAGO, IL 60677-6879
(502) 588-9490
(502) 272-5339
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
22815
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000845597
ANTHEM-NCMA
KY
01
—
157104
SIHO-NCMA
KY
01
—
50061767
PASSPORT-NCMA
KY
05
—
64228158
—
KY
Enumeration date
07/07/2005
Last updated
10/05/2022
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