Individual
DR. GUSTAVO VINCENT HUERTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1760 NICHOLASVILLE RD STE 202, LEXINGTON, KY 40503-1472
(859) 277-5711
Mailing address
1760 NICHOLASVILLE RD STE 202, LEXINGTON, KY 40503-1472
(859) 323-6162
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
54021
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R3798
KENTUCKY MEDICAL LICENSE
KY
Enumeration date
06/21/2015
Last updated
08/14/2020
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