Healthcare Provider Details

I. General information

NPI: 1710916176
Provider Name (Legal Business Name): JEFFREY DON CASE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 MEDICAL CENTER DR
PADUCAH KY
42003-7909
US

IV. Provider business mailing address

110 MEDICAL CENTER DR
PADUCAH KY
42003-7909
US

V. Phone/Fax

Practice location:
  • Phone: 270-443-2471
  • Fax: 270-443-5808
Mailing address:
  • Phone: 270-443-2471
  • Fax: 270-443-5808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number23959
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: