Individual
SUSAN K. SVETICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C.
Contact information
Practice address
1055 DOVE RUN RD, LEXINGTON, KY 40502-3536
(859) 268-0061
(859) 266-1152
Mailing address
1055 DOVE RUN RD, LEXINGTON, KY 40502-3536
(859) 268-0061
(859) 266-1152
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA119
KY
363AM0700X
Medical Physician Assistant
Primary
PA119
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37903705
MEDICAID LAB GROUP
KY
01
—
4000501
MEDICARE LAB GROUP
KY
05
—
95001194
—
KY
01
—
CB5773
RR MEDICARE GROUP
KY
01
—
P00036568
RR MEDICARE PIN
KY
Enumeration date
09/13/2006
Last updated
12/02/2009
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