Healthcare Provider Details

I. General information

NPI: 1346345667
Provider Name (Legal Business Name): SUSAN T. SEE P.A.-C., CSA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 12/02/2020
Certification Date: 12/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3350 PEPPERHILL RD
LEXINGTON KY
40502
US

IV. Provider business mailing address

3350 PEPPERHILL RD
LEXINGTON KY
40502-3840
US

V. Phone/Fax

Practice location:
  • Phone: 859-533-6891
  • Fax: 859-268-0989
Mailing address:
  • Phone: 859-533-6891
  • Fax: 859-269-0989

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number3126
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA539
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: