| Pattie A. Clay Internal Medicine-gina D'costa Md | |
|
789 Eastern Byp Suite 11 Richmond KY 40475-2415 | |
| (859) 624-0012 | |
| (859) 624-0899 |
| Full Name | Pattie A. Clay Internal Medicine-gina D'costa Md |
|---|---|
| Speciality | Internal Medicine - Geriatric Medicine |
| Location | 789 Eastern Byp, Richmond, Kentucky |
| Authorized Official Name and Position | Wendell C Mcclurg (CFO) |
| Authorized Official Contact | 8596240012 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pattie A. Clay Internal Medicine-gina D'costa Md 789 Eastern Byp Suite 11 Richmond KY 40475-2415 Ph: (859) 624-0012 | Pattie A. Clay Internal Medicine-gina D'costa Md 789 Eastern Byp Suite 11 Richmond KY 40475-2415 Ph: (859) 624-0012 |
| NPI Number | 1922371988 |
|---|---|
| Provider Enumeration Date | 02/21/2012 |
| Last Update Date | 02/21/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922371988 | NPI | - | NPPES |
| 64094576 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | (Kentucky) | Primary |
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