Organization
EGAN CLINIC PSC
Active
Organization
EGAN CLINIC PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYNN O EGAN MD (PRESIDENT)
(502) 228-7530
Entity
Organization
Contact information
Practice address
12945 W HIGHWAY 42, PROSPECT, KY 40059-9107
(502) 228-7530
(502) 228-7533
Mailing address
12945 W HIGHWAY 42, PROSPECT, KY 40059-9107
(502) 228-7530
(502) 228-7533
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
39726
KY
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100195370
—
KY
Enumeration date
03/02/2012
Last updated
07/24/2013
Update your record
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