Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 13948 | KY |
NPI | 1881804441 |
---|---|
Provider Name | Patrick J Serey |
First Address | Lexington, KY 40502-1204 |
Second Address | Lexington, KY 40508-3206 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2007 |
Last Update Date | 30/11/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
13948 | MEDICAL LICENSE (01) | KY |
64139488 | (05) | KY |
C64658 | (02) |