Healthcare Provider Details

I. General information

NPI: 1619039781
Provider Name (Legal Business Name): DEBORAH R FLOMENHOFT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2006
Last Update Date: 11/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 S LIMESTONE ST
LEXINGTON KY
40536-0284
US

IV. Provider business mailing address

138 LEADER AVE
LEXINGTON KY
40508-3215
US

V. Phone/Fax

Practice location:
  • Phone: 859-323-0079
  • Fax: 859-257-8675
Mailing address:
  • Phone: 859-257-7910
  • Fax: 859-257-7899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number35142
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License Number35142
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: