MEDICARE: DR. RACHEL H MATHIS M.D.

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	208600000X	Surgery Physician	270400	MA
2	208600000X	Surgery Physician	51703	KY

General Provider Information

NPI Number	:	1922368695
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RACHEL H MATHIS M.D.

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

Provider Business Practice Location Address
First Line	:	160 N EAGLE CREEK DR STE 201
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40509-2125
Country	:	US
Telephone Number	:	859-967-5520
Fax Number	:	859-967-5444

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

Provider Enumeration Date	:	05/29/2012
Last Update Date	:	05/29/2025

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