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General NPI Number Information
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NPI Number | 1942533575
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Entity Type | Organization
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Legal Business Name | ORTHO KENTUCKY PLLC
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Dates
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Enumeration Date | 09/15/2009
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Last Update Date | 07/19/2010
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Provider Practice Location Address
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Address Line | 1760 NICHOLASVILLE RD STE 604
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City | LEXINGTON
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State | KY
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Zip | 40503-1471
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Country | US
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Telephone | 859-255-9059
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Fax | 859-254-3112
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Provider Business Mailing Address
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Address Line | 1780 NICHOLASVILLE RD STE 501
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City | LEXINGTON
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State | KY
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Zip | 40503-1400
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Country | US
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Telephone | 859-278-3481
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Fax | 859-277-7365
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Authorized Official
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Title or Position | MEMBER
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Name | DR. LISA T DEGNORE
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Credential |
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Telephone | 859-278-3481
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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