Individual
DR. CLINTON SHAIN KITECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
810 JAMESTOWN ST, COLUMBIA, KY 42728-1010
(270) 384-4764
(270) 384-6228
Mailing address
810 JAMESTOWN ST, COLUMBIA, KY 42728-1010
(270) 384-4764
(270) 384-6228
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
03065
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100058480
—
KY
Enumeration date
01/24/2008
Last updated
03/02/2023
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