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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 64175722 | Medicaid | KY |
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All providers in Stanford, KY · Family Medicine Physician in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.