Healthcare Provider Details

I. General information

NPI: 1528992880
Provider Name (Legal Business Name): PEYTON MCKAY CASE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 WAR ADMIRAL STE 2
DANVILLE KY
40422-8625
US

IV. Provider business mailing address

131 ENTERPRISE RD
JOHNSTOWN NY
12095-3326
US

V. Phone/Fax

Practice location:
  • Phone: 859-800-6815
  • Fax:
Mailing address:
  • Phone: 859-800-6815
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number307232
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: