MEDICARE: DR. JORGE GABRIEL LODEIRO 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	207VM0101X	Maternal & Fetal Medicine Physician	40772	TN
2	207VM0101X	Maternal & Fetal Medicine Physician	60362	KY
3	207VM0101X	Maternal & Fetal Medicine Physician	P0085	TX

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

General Provider Information

NPI Number	:	1568409894
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JORGE GABRIEL LODEIRO MD

Provider Business Mailing Address
First Line	:	PO BOX 936
Second Line	:
City	:	LONDON
State	:	KY
Zip	:	40743-0936
Country	:	US
Telephone Number	:	606-330-7835
Fax Number	:	859-263-8669

Provider Business Practice Location Address
First Line	:	170 N EAGLE CREEK DR STE 110
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40509-9087
Country	:	US
Telephone Number	:	859-263-0141
Fax Number	:	859-263-8669

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

Provider Enumeration Date	:	06/02/2006
Last Update Date	:	12/08/2025

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