Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RA0401X | Internist - Addiction Medicine | 52839 | KY |
NPI | 1477915056 |
---|---|
Provider Name | Dr. Anna Maria South |
First Address | Lexington, KY 40536-0001 |
Second Address | Lexington, KY 40536-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2016 |
Last Update Date | 18/12/2019 |