Healthcare Provider Details

I. General information

NPI: 1932383833
Provider Name (Legal Business Name): ST. CLAIRE MEDICAL CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2007
Last Update Date: 08/17/2023
Certification Date: 08/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 MEDICAL CIRCLE
MOREHEAD KY
40351
US

IV. Provider business mailing address

PO BOX 968
MOREHEAD KY
40351-0968
US

V. Phone/Fax

Practice location:
  • Phone: 260-407-8000
  • Fax: 260-407-8014
Mailing address:
  • Phone: 606-783-6521
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number StateKY

VIII. Authorized Official

Name: DONALD H LLOYD II
Title or Position: CEO/PRESIDENT
Credential:
Phone: 606-783-6502