Individual
DR. ROBERT RUSSELL DENNISON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
108 HIDDEN GROVE LN, WINCHESTER, KY 40391-8845
(859) 527-6601
Mailing address
3439 BUCKHORN DRIVE, SUITE 160, LEXINGTON, KY 40515
(859) 368-8820
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD16062
KY
207RA0401X
Addiction Medicine (Internal Medicine) Physician
16062
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
KY
Enumeration date
12/21/2006
Last updated
06/24/2015
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