Individual
ADAM S BASTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
800 ROSE ST, LEXINGTON, KY 40536-0001
(859) 323-5000
Mailing address
800 ROSE ST, LEXINGTON, KY 40536-0001
(859) 323-5000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1553
KY
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
PA1553
KY
363AS0400X
Surgical Physician Assistant
PA1553
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100117850
—
KY
Enumeration date
02/10/2010
Last updated
08/17/2020
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