Healthcare Provider Details

I. General information

NPI: 1356756720
Provider Name (Legal Business Name): MEGAN MINCH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2014
Last Update Date: 12/04/2020
Certification Date: 12/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3084 LAKECREST CIR STE 100
LEXINGTON KY
40513-1972
US

IV. Provider business mailing address

230 LEXINGTON GREEN CIR STE 600
LEXINGTON KY
40503-3326
US

V. Phone/Fax

Practice location:
  • Phone: 859-219-6440
  • Fax: 859-219-6449
Mailing address:
  • Phone: 859-971-4695
  • Fax: 859-971-4604

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberR3565
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberTP505
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: