Doctor Name: | DOUGLAS J NESBITT |
NPI Number: | 1114916863 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 21624 |
Business Practice Address: | 120 N Eagle Creek Dr Ste 460 Lexington, KY - 405091827 |
Business Phone Number: | 8592637248 |
Business Fax Number: | 8592630714 |
Mailing Address: | 120 N Eagle Creek Dr Ste 460, LEXINGTON |
State: | KY |
Postal Code: | 405091827 |
Phone Number: | 8592637248 |
Fax Number: | 8592630714 |
NPI Enumeration Date: | 10/17/2005 |
NPI Last Update Date: | 12/01/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 21624 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |