Provider Demographics
NPI:1659315422
Name:SEGURA, MARCIA KAY (DC)
Entity Type:Individual
Prefix:DR
First Name:MARCIA
Middle Name:KAY
Last Name:SEGURA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1419 ALEXANDRIA PIKE STE B
Mailing Address - Street 2:
Mailing Address - City:FORT THOMAS
Mailing Address - State:KY
Mailing Address - Zip Code:41075-2540
Mailing Address - Country:US
Mailing Address - Phone:859-441-6058
Mailing Address - Fax:859-441-3092
Practice Address - Street 1:1419 ALEXANDRIA PIKE STE B
Practice Address - Street 2:
Practice Address - City:FORT THOMAS
Practice Address - State:KY
Practice Address - Zip Code:41075-2540
Practice Address - Country:US
Practice Address - Phone:859-441-6058
Practice Address - Fax:859-441-3092
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2011-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3766111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000048687OtherANTHEM
KY85002095Medicaid
KY85002095Medicaid
KYT466Medicare UPIN