Individual
KEVIN T SCULLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1720 NICHOLASVILLE RD STE 400, LEXINGTON, KY 40503-1475
(859) 277-5887
(859) 276-7638
Mailing address
1720 NICHOLASVILLE RD, SUITE 601, LEXINGTON, KY 40503-1475
(859) 277-5887
(859) 276-7638
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
22190
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060019842
RAILROAD MEDICARE
KY
05
—
6422190600
—
KY
Enumeration date
06/10/2006
Last updated
12/02/2020
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