MEDICARE: DR. MARCIA KAY SEGURA DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	3766	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000048687	OTHER	KY	ANTHEM
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659315422
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARCIA KAY SEGURA DC

Provider Business Mailing Address
First Line	:	1419 ALEXANDRIA PIKE STE B
Second Line	:
City	:	FORT THOMAS
State	:	KY
Zip	:	41075-2540
Country	:	US
Telephone Number	:	859-441-6058
Fax Number	:	859-441-3092

Provider Business Practice Location Address
First Line	:	1419 ALEXANDRIA PIKE STE B
Second Line	:
City	:	FORT THOMAS
State	:	KY
Zip	:	41075-2540
Country	:	US
Telephone Number	:	859-441-6058
Fax Number	:	859-441-3092

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2006
Last Update Date	:	01/13/2011

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