Provider Demographics
NPI:1205044070
Name:COMER, CLARA PRADA (MD)
Entity Type:Individual
Prefix:
First Name:CLARA
Middle Name:PRADA
Last Name:COMER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CLARA
Other - Middle Name:P
Other - Last Name:COMER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:6105 REGAL SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40205-3323
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6105 REGAL SPRINGS DR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205-3323
Practice Address - Country:US
Practice Address - Phone:502-552-6121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY18584208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice