Healthcare Provider Details

I. General information

NPI: 1285921932
Provider Name (Legal Business Name): ROBIN MCHALE POLLY D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2011
Last Update Date: 02/24/2021
Certification Date: 02/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 VETERANS DR
LEXINGTON KY
40502-2235
US

IV. Provider business mailing address

1101 VETERANS DRIVE
LEXINGTON KY
40502
US

V. Phone/Fax

Practice location:
  • Phone: 859-233-4511
  • Fax: 859-281-3928
Mailing address:
  • Phone: 859-233-4511
  • Fax: 859-281-3928

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number03698
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberKY03698
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: