Healthcare Provider Details

I. General information

NPI: 1902074503
Provider Name (Legal Business Name): WILLIAM RAFAEL SANCHEZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2008
Last Update Date: 07/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 E NEW CIRCLE RD
LEXINGTON KY
40505-2619
US

IV. Provider business mailing address

450 E NEW CIRCLE RD
LEXINGTON KY
40505-2619
US

V. Phone/Fax

Practice location:
  • Phone: 859-523-3797
  • Fax: 859-523-3948
Mailing address:
  • Phone: 859-523-3797
  • Fax: 859-523-3948

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number42437
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number42437
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberAU-2903599-9914
License Number StateAZ
# 4
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number050155
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: