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General NPI Number Information
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NPI Number | 1689814675
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Entity Type | Individual
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Provider Name | TONYA JUSTICE D.O.
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Gender | Female
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Dates
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Enumeration Date | 03/03/2009
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Last Update Date | 08/10/2021
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Provider Practice Location Address
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Address Line | 830 S LIMESTONE
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City | LEXINGTON
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State | KY
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Zip | 40536-8525
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Country | US
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Telephone | 859-323-2778
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Fax | 859-257-8708
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Provider Business Mailing Address
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Address Line | PO BOX 636493
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City | CINCINNATI
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State | OH
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Zip | 45263-6493
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Country | US
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Telephone | 513-981-5130
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Fax | 513-981-5015
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 03387
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 03387
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 03387
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License Number State | KY
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