Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 38138 | KY |
NPI | 1134187859 |
---|---|
Provider Name | Dr. Ellen J Flinchum |
First Address | Lexington, KY 40504-2701 |
Second Address | Lexington, KY 40504 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2006 |
Last Update Date | 31/07/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
64074545 | (05) | KY |
H56005 | (02) | KY |