Provider Demographics
NPI:1417489352
Name:CLANCY, KATE (MD)
Entity Type:Individual
Prefix:
First Name:KATE
Middle Name:
Last Name:CLANCY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3600 KOLBE RD STE 206
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44053-1652
Mailing Address - Country:US
Mailing Address - Phone:440-282-7600
Mailing Address - Fax:440-282-7811
Practice Address - Street 1:3600 KOLBE RD STE 206
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44053-1652
Practice Address - Country:US
Practice Address - Phone:440-222-4140
Practice Address - Fax:440-222-4141
Is Sole Proprietor?:No
Enumeration Date:2017-03-30
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35.149280207YX0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck