Provider Demographics
NPI:1023428695
Name:HAY, CASEY YEAKEL (MD)
Entity type:Individual
Prefix:
First Name:CASEY
Middle Name:YEAKEL
Last Name:HAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CASEY
Other - Middle Name:
Other - Last Name:YEAKEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 23229
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42304-3229
Mailing Address - Country:US
Mailing Address - Phone:270-688-1330
Mailing Address - Fax:270-688-1338
Practice Address - Street 1:910 WALLACE AVE STE 207
Practice Address - Street 2:
Practice Address - City:LEITCHFIELD
Practice Address - State:KY
Practice Address - Zip Code:42754-2408
Practice Address - Country:US
Practice Address - Phone:270-259-2714
Practice Address - Fax:270-259-3593
Is Sole Proprietor?:No
Enumeration Date:2014-05-05
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY52281207Y00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100603000Medicaid