Provider Demographics
NPI:1215386750
Name:KARRICK, SHANDY MARCUS (DO)
Entity Type:Individual
Prefix:
First Name:SHANDY
Middle Name:MARCUS
Last Name:KARRICK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:230 LEXINGTON GREEN CIR STE 600
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-3326
Mailing Address - Country:US
Mailing Address - Phone:859-971-4695
Mailing Address - Fax:859-971-4604
Practice Address - Street 1:801 EASTERN BYP
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-2751
Practice Address - Country:US
Practice Address - Phone:859-625-3603
Practice Address - Fax:859-625-3757
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-06
Last Update Date:2019-06-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY04296207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine