Provider Demographics
NPI:1720091770
Name:VICHER, CLARITA V (MD)
Entity Type:Individual
Prefix:MS
First Name:CLARITA
Middle Name:V
Last Name:VICHER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 595
Mailing Address - Street 2:
Mailing Address - City:MC DOWELL
Mailing Address - State:KY
Mailing Address - Zip Code:41647-0595
Mailing Address - Country:US
Mailing Address - Phone:606-377-3427
Mailing Address - Fax:
Practice Address - Street 1:9879 KY RT 122 HOSPITAL DRIVE
Practice Address - Street 2:SUITE 138
Practice Address - City:MCDOWELL
Practice Address - State:KY
Practice Address - Zip Code:41647-0595
Practice Address - Country:US
Practice Address - Phone:606-377-2135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2011-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY21155207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64211550Medicaid
KY64211550Medicaid
KY00689001Medicare PIN