MEDICARE: DAVID BARTLESON DRAKE 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	2082S0105X	Surgery of the Hand (Plastic Surgery) Physician	27223	KY
2	2086S0105X	Surgery of the Hand (Surgery) Physician	27223	KY
3	2086S0122X	Plastic and Reconstructive Surgery Physician	0101042348	VA
4	2086S0122X	Plastic and Reconstructive Surgery Physician	27223	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	27223	OTHER	KY	KY LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902975527
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID BARTLESON DRAKE MD

Provider Business Mailing Address
First Line	:	740 SOUTH LIMESTONE KENTUCKY CLINIC 4TH FLOOR K454
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40536-0001
Country	:	US
Telephone Number	:	859-323-7506
Fax Number	:	859-323-3823

Provider Business Practice Location Address
First Line	:	2195 HARRODSBURG RD FL 2
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40504-3516
Country	:	US
Telephone Number	:	859-323-8082
Fax Number	:	859-257-5901

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

Provider Enumeration Date	:	11/07/2006
Last Update Date	:	03/09/2023

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Directions to “ DAVID BARTLESON DRAKE MD” Practice Location

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