Healthcare Provider Details

I. General information

NPI: 1326146473
Provider Name (Legal Business Name): COURTNEY A MARKHAM-ABEDI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

EASTERN STATE HOSPITAL 627 W FOURTH ST
LEXINGTON KY
40508-1294
US

IV. Provider business mailing address

EASTERN STATE HOSPITAL 627 W FOURTH ST
LEXINGTON KY
40508-1294
US

V. Phone/Fax

Practice location:
  • Phone: 859-246-7000
  • Fax: 859-246-7023
Mailing address:
  • Phone: 859-246-7000
  • Fax: 859-246-7023

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number40026
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: