Individual
DR. JOHN D MICHELMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1055 WELLINGTON WAY, SUITE 110, LEXINGTON, KY 40513-1259
(859) 219-2822
(859) 219-2825
Mailing address
PO BOX 9150, PADUCAH, KY 42002-9150
(270) 744-9600
(270) 744-0834
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
37523
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000364311
BLUE CROSS
KY
05
—
64054257
—
KY
Enumeration date
08/30/2006
Last updated
04/27/2011
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