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Organization
KENTUCKY DIABETES ENDOCRINOLOGY CENTER, PSC
Active
Organization
KENTUCKY DIABETES ENDOCRINOLOGY CENTER, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LYLE CHRISTOPHER MYERS M.D. (CORPORATE PRESIDENT)
(859) 227-8015
Entity
Organization
Contact information
Practice address
417 E CAMBRIDGE LN, NICHOLASVILLE, KY 40356-8132
(859) 351-3801
Mailing address
417 E CAMBRIDGE LN, NICHOLASVILLE, KY 40356-8132
(859) 351-3801
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1408233
UMWA
—
01
—
208448
BLACK LUNG
—
05
—
659 282 36
—
KY
01
—
K008543
CHAMPUS
—
Enumeration date
12/14/2006
Last updated
01/07/2022
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