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General NPI Number Information
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NPI Number | 1821591926
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Entity Type | Individual
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Provider Name | ANDREW L. FOZZARD MD
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Gender | Male
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Dates
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Enumeration Date | 03/14/2018
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Last Update Date | 06/03/2025
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Provider Practice Location Address
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Address Line | 1401 HARRODSBURG RD STE C405
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City | LEXINGTON
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State | KY
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Zip | 40504-1748
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Country | US
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Telephone | 859-276-4429
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Fax | 859-313-1095
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Provider Business Mailing Address
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Address Line | PO BOX 936
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City | LONDON
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State | KY
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Zip | 40743-0936
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Country | US
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Telephone | 606-330-7835
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Fax | 859-313-1095
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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 | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 55472
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number | 55472
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License Number State | KY
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