Individual
SUSAN E. LIDDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1221 S BROADWAY, LEXINGTON, KY 40504
(859) 258-4673
(859) 258-6539
Mailing address
1221 S BROADWAY, LEXINGTON, KY 40504-2701
(859) 258-6520
(859) 258-6539
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
26691
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64266919
—
KY
Enumeration date
07/14/2006
Last updated
06/05/2019
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