Provider Demographics
NPI:1003315227
Name:HARTLEY, WILLIAM CLAYTON (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:CLAYTON
Last Name:HARTLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1760 NICHOLASVILLE RD STE 101
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-1410
Mailing Address - Country:US
Mailing Address - Phone:859-899-7950
Mailing Address - Fax:859-260-5150
Practice Address - Street 1:1760 NICHOLASVILLE RD STE 101
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-1410
Practice Address - Country:US
Practice Address - Phone:859-899-7950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-02
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY54253207QS0010X, 207QS0010X
GA83570207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine