MEDICARE: EPOCH HEALTH AND WELLNESS LLC

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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1538712344
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EPOCH HEALTH AND WELLNESS LLC

Provider Business Mailing Address
First Line	:	4124 BOONE CREEK RD
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40509-9712
Country	:	US
Telephone Number	:	859-264-7886
Fax Number	:

Provider Business Practice Location Address
First Line	:	2121 RICHMOND RD STE 201
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40502-1213
Country	:	US
Telephone Number	:	859-309-7400
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	RONDAL GOBLE
Credential	:	MD
Telephone Number	:	859-227-1251

Provider Enumeration Date	:	07/20/2019
Last Update Date	:	04/15/2022

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Directions to “EPOCH HEALTH AND WELLNESS LLC ” Practice Location

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