Healthcare Provider Details

I. General information

NPI: 1518908995
Provider Name (Legal Business Name): FREDERICK UELAND MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 05/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 ROSE STREET
LEXINGTON KY
40536-0001
US

IV. Provider business mailing address

2333 ALUMNI PARK PLZ SUITE 200
LEXINGTON KY
40517-4012
US

V. Phone/Fax

Practice location:
  • Phone: 859-323-5345
  • Fax:
Mailing address:
  • Phone: 859-257-7910
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number28124
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number28124
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number28124
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: