Individual
MADISON GONSALVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
205 CHARLES T WETHINGTON BUILDING, LEXINGTON, KY 40536-8515
(859) 257-5001
Mailing address
205 CHARLES T WETHINGTON BUILDING, LEXINGTON, KY 40536-8515
(859) 257-5001
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
06/05/2023
Last updated
08/29/2024
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