Healthcare Provider Details

I. General information

NPI: 1003278284
Provider Name (Legal Business Name): DOROTHY MCCORD MAES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DOROTHY DICKINSON MCCORD MD

II. Dates (important events)

Enumeration Date: 03/25/2016
Last Update Date: 05/25/2023
Certification Date: 05/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 S LIMESTONE
LEXINGTON KY
40536-0001
US

IV. Provider business mailing address

900 S LIMESTONE CTW 304
LEXINGTON KY
40536-0293
US

V. Phone/Fax

Practice location:
  • Phone: 859-323-9057
  • Fax: 859-323-9502
Mailing address:
  • Phone: 859-323-6561
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberR4137
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number53848
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number53848
License Number StateKY
# 4
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number53848
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: