Healthcare Provider Details

I. General information

NPI: 1548795081
Provider Name (Legal Business Name): WILLIAM JAMES MELVIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2017
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 ROSE ST
LEXINGTON KY
40536-7001
US

IV. Provider business mailing address

800 ROSE ST
LEXINGTON KY
40536-7001
US

V. Phone/Fax

Practice location:
  • Phone: 859-218-4818
  • Fax:
Mailing address:
  • Phone: 859-218-4818
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number62116
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: