Individual
THERESE JEANNE BOCKLAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
800 ROSE ST # MS 117, LEXINGTON, KY 40536
(859) 323-5425
Mailing address
800 ROSE ST # MS 117, LEXINGTON, KY 40536-0298
(859) 323-5425
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
TP128
KY
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
TP128
KY
Other
Enumeration date
07/30/2006
Last updated
06/04/2019
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