Individual
AUSTIN STACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 MEDICAL VILLAGE DRIVE, EDGEWOOD, KY 41017-3403
(859) 344-1600
Mailing address
650 SPRUCEWOOD LN, ERLANGER, KY 41018-1062
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
10004430A
IN
363A00000X
Physician Assistant
Primary
PA3206
KY
363A00000X
Physician Assistant
—
—
Other
Enumeration date
01/23/2023
Last updated
07/02/2024
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