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General NPI Number Information
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NPI Number | 1518079300
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Entity Type | Individual
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Provider Name | BARETTA R CASEY MD
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Gender | Female
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 02/22/2008
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Provider Practice Location Address
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Address Line | 750 MORTON BLVD
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City | HAZARD
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State | KY
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Zip | 41701-9469
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Country | US
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Telephone | 606-439-1559
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Fax |
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Provider Business Mailing Address
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Address Line | 2333 ALUMNI PARK PLZ SUITE 200
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City | LEXINGTON
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State | KY
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Zip | 40517-4012
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Country | US
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Telephone | 859-218-5677
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 29143
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 207QA0000X
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Taxonomy Name | Adolescent Medicine (Family Medicine) Physician
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License Number | 29143
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | 29143
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License Number State | KY
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Taxonomy #4
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | 29143
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License Number State | KY
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Taxonomy #5
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | 29143
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License Number State | KY
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Taxonomy #6
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | 29143
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License Number State | KY
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