Individual
BUDDY HURT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
117 CROSSFIELD DR STE B, VERSAILLES, KY 40383-1844
(859) 873-9188
(859) 873-0870
Mailing address
1221 S BROADWAY, LEXINGTON, KY 40504-2701
(859) 258-6200
(859) 258-6203
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02563
KY
207Q00000X
Family Medicine Physician
2177
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2662604
—
OH
05
—
3810005690
—
WV
05
—
64001886
—
KY
Enumeration date
06/27/2006
Last updated
02/14/2023
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