Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | R4739 | KY |
NPI | 1235634064 |
---|---|
Provider Name | Emily Diane Hogancamp |
First Address | Lexington, KY 40536-0293 |
Second Address | Lexington, KY 40536-0293 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2018 |
Last Update Date | 11/07/2019 |