Individual
DR. KATHY DARLENE SHORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
828 LANE ALLEN RD STE 219, LEXINGTON, KY 40504
(177) 821-5773
(317) 780-5538
Mailing address
PO BOX 3299, CARSON CITY, NV 89702-3299
(317) 782-1577
(317) 780-5538
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
03329
KY
207Q00000X
Family Medicine Physician
34007335S
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000694607
ANTHEM
KY
01
—
50031082
PASSPORT
KY
05
—
7100147240
—
KY
Enumeration date
06/23/2006
Last updated
10/23/2019
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