Charles Crase, MD

Individual provider Active NPI Family Medicine Physician · Stanford, KY

NPI 1710060876 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1710060876
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
17572 (KY)
Practice address
116 Metker TRL
Stanford, KY 40484-1065
Phone
(859) 239-2379
Fax
(859) 239-6898
NPI assigned
Oct 23, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 17572 KY Yes

Addresses

Primary practice location

116 Metker TRL
Stanford, KY 40484-1065

Mailing address

PO Box 990
Danville, KY 40423-0990
Phone (859) 239-2379

Other identifiers

IdentifierTypeStateIssuer
64175722MedicaidKY

Other providers in Stanford, KY

All providers in Stanford, KY · Family Medicine Physician in Kentucky

Sources for this page

Verify at the official NPI Registry.