Provider Demographics
NPI:1609873553
Name:CLORE, LEE STANTON JR (MD)
Entity Type:Individual
Prefix:DR
First Name:LEE
Middle Name:STANTON
Last Name:CLORE
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3604 WATHENS CROSSING
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42301-7035
Mailing Address - Country:US
Mailing Address - Phone:270-684-6144
Mailing Address - Fax:270-684-2944
Practice Address - Street 1:3604 WATHENS CROSSING
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42301-7035
Practice Address - Country:US
Practice Address - Phone:270-684-6144
Practice Address - Fax:270-684-2944
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2021-12-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY33785207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY604818OtherWELLCARE OF KENTUCKY, MCO
KY00541691OtherANTHEM MEDICAID
KY64337850Medicaid
KY64337850Medicaid
KY604818OtherWELLCARE OF KENTUCKY, MCO