Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 008238 | GA |
N | 207Q00000X | Family Doctor | 15805 | ND |
Y | 207QS0010X | Family Doctor - Sports Medicine | TP532 | KY |
NPI | 1164884904 |
---|---|
Provider Name | Dr. Frank Taddeo |
First Address | London, KY 40743-0936 |
Second Address | Lexington, KY 40509-2697 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2016 |
Last Update Date | 02/09/2020 |