Individual
GARY R CONRAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 ROSE ST, HX318, LEXINGTON, KY 40536-0293
(859) 323-5069
Mailing address
800 ROSE ST, HX318, LEXINGTON, KY 40536-0293
(859) 323-5069
Taxonomy
Speciality
Code
Description
License number
State
2085N0904X
Nuclear Radiology Physician
Primary
26309
KY
2085R0202X
Diagnostic Radiology Physician
26309
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64263098
—
KY
Enumeration date
06/12/2006
Last updated
12/07/2012
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