MEDICARE: DR. IHAB YOUSSEF LABATIA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208100000X	Physical Medicine & Rehabilitation Physician	49262	KY
2	2081P0004X	Spinal Cord Injury Medicine Physician	43140	TN
3	2081P0004X	Spinal Cord Injury Medicine Physician	49262	KY
4	208VP0000X	Pain Medicine Physician	49262	KY
5	208VP0014X	Interventional Pain Medicine Physician	49262	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	4179314	OTHER	TN	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093776841
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. IHAB YOUSSEF LABATIA MD

Provider Business Mailing Address
First Line	:	853 LANE ALLEN RD
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40504-3605
Country	:	US
Telephone Number	:	859-523-5300
Fax Number	:	859-523-5855

Provider Business Practice Location Address
First Line	:	853 LANE ALLEN RD
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40504-3605
Country	:	US
Telephone Number	:	859-523-5300
Fax Number	:	859-523-5855

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/31/2006
Last Update Date	:	02/24/2019

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