Healthcare Provider Details

I. General information

NPI: 1356380026
Provider Name (Legal Business Name): JACQUELINE CAREY FISTER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JACQUELINE CAREY MD

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 09/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 SOUTH LIMESTONE WOMEN'S HEALTH CLINIC
LEXINGTON KY
40536-0001
US

IV. Provider business mailing address

UK DIVISION OF RHEUMATOLOGY AND 740 S. LIMESTONE, J509 KY CLINIC
LEXINGTON KY
40536-0284
US

V. Phone/Fax

Practice location:
  • Phone: 859-323-3900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number39714
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: