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General NPI Number Information
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NPI Number | 1568082469
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Entity Type | Individual
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Provider Name | JOSHUA LEE VANDEBURGH MD
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Gender | Male
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Dates
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Enumeration Date | 04/21/2020
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Last Update Date | 06/16/2025
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Provider Practice Location Address
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Address Line | 1720 NICHOLASVILLE RD STE 601A
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City | LEXINGTON
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State | KY
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Zip | 40503-1404
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Country | US
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Telephone | 859-639-0905
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Fax | 859-639-0906
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Provider Business Mailing Address
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Address Line | 1720 NICHOLASVILLE RD STE 601A
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City | LEXINGTON
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State | KY
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Zip | 40503-1404
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Country | US
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Telephone | 859-639-0905
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Fax | 859-639-0906
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084V0102X
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Taxonomy Name | Vascular Neurology Physician
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License Number | TP469
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License Number State | KY
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