Individual
VICKIE C CHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2626 ALEXANDRIA PIKE, HIGHLAND HEIGHTS, KY 41076-1530
(859) 781-4111
(859) 441-5214
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(859) 781-4111
(859) 441-5214
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
41001
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2790967
—
OH
05
—
7100019390
—
KY
01
—
P00408798
RAILROAD MEDICARE
KY
01
—
P00847810
RAILROAD MEDICARE
KY
Enumeration date
06/06/2007
Last updated
04/10/2020
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