Individual
DR. REVA DUFF TACKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1720 NICHOLASVILLE RD STE 702, LEXINGTON, KY 40503-1489
(859) 264-8811
(859) 264-8822
Mailing address
1720 NICHOLASVILLE RD STE 702, LEXINGTON, KY 40503-1489
(859) 264-8811
(859) 264-8822
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
20064
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64220643
—
KY
Enumeration date
01/11/2006
Last updated
02/03/2022
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