Graduated: 2003
NPI: 1306951934
Practice Locations (2)
KENTUCKY MSO LLC
1502 OXFORD DR, SUITE 100
GEORGETOWN, KY 403248096
5025703785
KENTUCKYONE HEALTH MEDICAL GROUP INC
3581 HARRODSBURG RD, SUITE 350
LEXINGTON, KY 405131140
8593133400
Source: CMS National Downloadable File, September 2026.