Individual
LEON J. RAVVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1401 HARRODSBURG RD, SUITE A-540, LEXINGTON, KY 40504-3751
(859) 258-6760
(859) 258-6512
Mailing address
1401 HARRODSBURG RD, SUITE A-540, LEXINGTON, KY 40504-3751
(859) 258-6760
(859) 258-6512
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
20154
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36000818
ASC MEDICAID GROUP
KY
01
—
37903705
MEDICAID LAB GROUP
KY
01
—
4000501
MEDICARE LAB GROUP
KY
05
—
64201544
—
KY
01
—
ASC1019
ASC MEDICARE GROUP
KY
01
—
CB5773
RR MEDICARE GROUP
KY
Enumeration date
07/12/2006
Last updated
11/02/2007
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