Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 40221 | KY |
N | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 40221 | KY |
NPI | 1063453470 |
---|---|
Provider Name | Dr. Rudolph Michael Tovar |
First Address | Lexington, KY 40508-1935 |
Second Address | Lexington, KY 40536-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2006 |
Last Update Date | 24/06/2020 |