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Individual

DR. KELLY S TATE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
118 S MAIN ST, ELKTON, KY 42220-8863
(270) 265-5023
(270) 265-5026
Mailing address
118 S MAIN ST, ELKTON, KY 42220-8863
(270) 265-5023
(270) 265-5026

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
27148
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
64271489
KY
Enumeration date
05/18/2006
Last updated
06/14/2024
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