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Individual

HA THANH LE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
914 N DIXIE AVE, SUITE 100, ELIZABETHTOWN, KY 42701-2520
(270) 765-6149
(270) 737-5235
Mailing address
914 N DIXIE AVE, SUITE 100, ELIZABETHTOWN, KY 42701-2520
(270) 765-6149
(270) 737-5235

Taxonomy

Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
18501
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000047264
ANTHEM BCBS
KY
01
1050773
PASSPORT HEALTH PLAN
KY
01
110018583
RAILROAD RETIREMENT
KY
01
203585100
DEPT OF LABOR
KY
01
2432966000
PASSPORT ADVANTAGE
KY
05
64185010
KY
Enumeration date
08/09/2005
Last updated
03/07/2023
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