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General NPI Number Information
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NPI Number | 1316011059
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Entity Type | Organization
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Legal Business Name | HAMBURG GASTROENTEROLOGY, PLLC
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Dates
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Enumeration Date | 11/17/2006
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Last Update Date | 05/28/2009
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Provider Practice Location Address
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Address Line | 1795 ALYSHEBA WAY SUITE 1003
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City | LEXINGTON
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State | KY
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Zip | 40509
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Country | US
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Telephone | 859-543-1777
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Fax | 859-543-1776
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Provider Business Mailing Address
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Address Line | 1795 ALYSHEBA WAY SUITE 1003
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City | LEXINGTON
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State | KY
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Zip | 40509
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Country | US
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Telephone | 859-543-1777
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Fax | 859-543-1776
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Authorized Official
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Title or Position | GASTROENTEROLOGIST OWNER
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Name | DR. KAREN S JENNINGS-CONKLIN
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Credential | MD
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Telephone | 859-543-1777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 34156
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License Number State | KY
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