Individual
LISA T DEGNORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1760 NICHOLASVILLE RD STE 101, LEXINGTON, KY 40503-1410
(859) 899-7950
(859) 260-5150
Mailing address
1760 NICHOLASVILLE RD STE 101, LEXINGTON, KY 40503-1410
(859) 899-7950
(859) 260-5150
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
29499
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000047280
BCBS
KY
01
—
4603229
AETNA
KY
01
—
61-0979936
TAX ID
KY
05
—
64294994
—
KY
Enumeration date
06/09/2006
Last updated
12/03/2020
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