Individual
REBECCA G BOSOMWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1701 ALEXANDRIA DR, LEXINGTON, KY 40504-3149
(859) 277-3490
(859) 278-5014
Mailing address
1701 ALEXANDRIA DR, LEXINGTON, KY 40504-3149
(859) 277-3490
(859) 278-5014
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
30547
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64076706
—
KY
Enumeration date
06/28/2005
Last updated
05/12/2020
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