Healthcare Provider Details

I. General information

NPI: 1033189295
Provider Name (Legal Business Name): LEIGH ANN CARTER BEARD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 10/20/2021
Certification Date: 10/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 SHAKER DR STE 132
LEXINGTON KY
40504-3663
US

IV. Provider business mailing address

715 SHAKER DR STE 132
LEXINGTON KY
40504-3663
US

V. Phone/Fax

Practice location:
  • Phone: 859-288-5004
  • Fax: 859-288-5007
Mailing address:
  • Phone: 859-288-5004
  • Fax: 859-288-5007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License Number40054
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: