Egan Clinic Psc

NPI #1700150109 in Prospect, Kentucky

Provider Information

NPI Number: 1700150109
Entity Type: Organization
Organization Name: Egan Clinic Psc
Primary Specialty: Internal Medicine
Enumeration Date: Mar 2, 2012
Last Updated: Jul 24, 2013

Practice Location

Address: 12945 W HIGHWAY 42
City: Prospect
State: Kentucky
ZIP Code: 40059-9107
Phone: (502) 228-7530

Authorized Official

Name: LYNN O EGAN, MD
Title: PRESIDENT
Phone: (502) 228-7530

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X
Internal Medicine	207R00000X	Primary

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