Individual
MATTHEW KEITH BACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
800 ROSE ST, MN470, LEXINGTON, KY 40536-0001
(859) 338-4096
Mailing address
800 ROSE ST, MN470, LEXINGTON, KY 40536-0001
(859) 338-4096
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
44966
KY
Other
Enumeration date
11/12/2008
Last updated
08/12/2015
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