Healthcare Provider Details

I. General information

NPI: 1134142938
Provider Name (Legal Business Name): STEPHEN C. UMANSKY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 05/06/2025
Certification Date: 05/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1207 S BROADWAY
LEXINGTON KY
40504-2701
US

IV. Provider business mailing address

1207 S BROADWAY
LEXINGTON KY
40504-2701
US

V. Phone/Fax

Practice location:
  • Phone: 859-258-8575
  • Fax: 859-258-8562
Mailing address:
  • Phone: 859-258-6200
  • Fax: 859-258-6203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number37480
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number37480
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: