Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 14493 | KY |
Y | 208600000X | Surgeon | 14493 | KY |
NPI | 1003813411 |
---|---|
Provider Name | Dr. Edwin J. Nighbert |
First Address | Lexington, KY 40504-3751 |
Second Address | Lexington, KY 40504-3751 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2005 |
Last Update Date | 12/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
64144934 | (05) | KY |
C62861 | (02) | KY |
CF7805 | RAILROAD MEDICARE (01) | KY |
CJ2601 | RAILROAD MEDICARE (01) | KY |
CN8331 | RAILROAD MEDICARE (01) | KY |
P00209151 | RRMC PROVIDER NUMBER (01) | KY |