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General NPI Number Information
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NPI Number | 1205341542
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Entity Type | Organization
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Legal Business Name | ADVANCED CENTER FOR ARTHRITIS & OSTEOPOROSIS KENTUCKY,PLLC
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Dates
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Enumeration Date | 12/08/2017
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 3284 EAGLE VIEW LN
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City | LEXINGTON
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State | KY
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Zip | 40509-1851
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Country | US
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Telephone | 859-278-2575
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Fax | 859-277-1843
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Provider Business Mailing Address
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Address Line | 3210 BEACON ST
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City | LEXINGTON
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State | KY
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Zip | 40513-1950
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Country | US
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Telephone | 859-278-2575
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Fax | 859-277-1843
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Authorized Official
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Title or Position | EMPLOYER
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Name | DR. MARYAM KHAWARI
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Credential | MD
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Telephone | 859-278-2575
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 47166
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License Number State | KY
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