Unknown Individual – Pediatric Adolescent Medicine Physician, NPI 1609827872
Pediatric Adolescent Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
496, Southland Drive, Deerfield, Lexington, Fayette County, Kentucky, 40503, United States
LEXINGTON, KY 405031827
Phone: (859) 288-2392
Fax: (859) 721-3918
Type: Mailing
Bryan Station Road, Bryan Station, Lexington, Fayette County, Kentucky, 40361:40516, United States
LEXINGTON, KY 405052144
Phone: (859) 288-2425
Fax: (859) 721-3918
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 40503)
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