Individual
DR. GLENN R PROUDFOOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1221 S BROADWAY, LEXINGTON, KY 40504-2701
(859) 258-4000
(859) 258-6203
Mailing address
1221 S BROADWAY, LEXINGTON, KY 40504-2701
(859) 258-6200
(859) 258-6203
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
24423
KY
207Q00000X
Family Medicine Physician
24423
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64244239
—
KY
Enumeration date
07/04/2006
Last updated
06/15/2023
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