Healthcare Provider Details

I. General information

NPI: 1780263269
Provider Name (Legal Business Name): MCKENZIE CLAPP MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2021
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

908 MEMORIAL CT STE 302
ELIZABETHTOWN KY
42701-2562
US

IV. Provider business mailing address

525 E MARKET ST
AKRON OH
44304-1619
US

V. Phone/Fax

Practice location:
  • Phone: 270-979-7118
  • Fax: 270-979-7126
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberTP396
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: