Healthcare Provider Details

I. General information

NPI: 1164635553
Provider Name (Legal Business Name): EMILY A DEFRANCO DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2007
Last Update Date: 11/10/2023
Certification Date: 11/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 E MAXWELL ST STE 140
LEXINGTON KY
40508-2678
US

IV. Provider business mailing address

PO BOX 636256 CENTRAL CREDENTIALING
CINCINNATI OH
45263-0001
US

V. Phone/Fax

Practice location:
  • Phone: 859-323-0005
  • Fax: 859-323-0790
Mailing address:
  • Phone: 513-585-5505
  • Fax: 513-585-5511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number34-009377
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number2005006928
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number34 009377
License Number StateOH
# 4
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number02590
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: