Healthcare Provider Details

I. General information

NPI: 1740208461
Provider Name (Legal Business Name): DAVID MICHAEL PRESTON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 05/09/2022
Certification Date: 05/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 VETERANS DR
LEXINGTON KY
40502-2235
US

IV. Provider business mailing address

1101 VETERANS DR
LEXINGTON KY
40502-2235
US

V. Phone/Fax

Practice location:
  • Phone: 859-233-4511
  • Fax: 859-381-5824
Mailing address:
  • Phone: 859-233-4511
  • Fax: 859-381-5824

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number38372
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: