Medical school: UNIVERSITY OF KENTUCKY COLLEGE OF MEDICINE
Graduated: 1996
NPI: 1144225111
Practice Locations (2)
STANFORD WELLCARE CLINIC PLLC
132 FRONTIER BLVD, SUITE 101
STANFORD, KY 404848513
STANFORD WELLCARE CLINIC PLLC
132 FRONTIER BLVD, SUITE 101
STANFORD, KY 404848663
6067275757
Source: CMS National Downloadable File, September 2026.