Provider Demographics
NPI:1164428546
Name:KOCAN, KLAUDE P (DC)
Entity Type:Individual
Prefix:DR
First Name:KLAUDE
Middle Name:P
Last Name:KOCAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2182 DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:FT MITCHELL
Mailing Address - State:KY
Mailing Address - Zip Code:41017-2902
Mailing Address - Country:US
Mailing Address - Phone:859-344-6001
Mailing Address - Fax:859-344-6005
Practice Address - Street 1:2182 DIXIE HWY
Practice Address - Street 2:
Practice Address - City:FT MITCHELL
Practice Address - State:KY
Practice Address - Zip Code:41017-2902
Practice Address - Country:US
Practice Address - Phone:859-344-6001
Practice Address - Fax:859-344-6005
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-22
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4464111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY85000461Medicaid
KY6104901OtherMEDICARE PTAN
KY6104901OtherMEDICARE PTAN
KYU79289Medicare UPIN