Graduated: 1997
NPI: 1669537601
Practice Locations (2)
KENTUCKY MEDICAL SERVICES FOUNDATION, INC
125 E MAXWELL ST
LEXINGTON, KY 405082678
8593233231
PRISMA HEALTH MEDICAL GROUP-MIDLANDS
2 MEDICAL PARK RD, SUITE 106
COLUMBIA, SC 292036839
8034344480
Source: CMS National Downloadable File, September 2026.