Healthcare Provider Details

I. General information

NPI: 1790703007
Provider Name (Legal Business Name): STEPHEN J. MONNIG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 09/26/2024
Certification Date: 09/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2444 HARRODSBURG RD
LEXINGTON KY
40503-2162
US

IV. Provider business mailing address

1221 S BROADWAY
LEXINGTON KY
40504-2701
US

V. Phone/Fax

Practice location:
  • Phone: 859-258-6950
  • Fax: 859-258-6995
Mailing address:
  • Phone: 859-258-4361
  • Fax: 859-258-4329

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number30574
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: