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General NPI Number Information
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NPI Number | 1629055868
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Entity Type | Individual
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Provider Name | PATRICIO ROSA SIERRA MD
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Gender | Male
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Dates
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Enumeration Date | 12/29/2005
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Last Update Date | 09/30/2025
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Provider Practice Location Address
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Address Line | 1010 WOODLAND DR
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City | ELIZABETHTOWN
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State | KY
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Zip | 42701-3706
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Country | US
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Telephone | 270-706-5171
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Fax | 270-706-5738
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Provider Business Mailing Address
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Address Line | 1665 QUIRKS RUN RD
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City | DANVILLE
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State | KY
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Zip | 40422-8830
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Country | US
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Telephone | 859-236-4269
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Fax | 859-545-4945
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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 | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 51570
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | ME111938
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License Number State | FL
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