Individual
SONY THEKKETHALA SEBASTIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2201 LEXINGTON AVE, ASHLAND, KY 41101-2843
(606) 408-4000
(606) 408-6825
Mailing address
PO BOX 2379, ASHLAND, KY 41105-2379
(606) 408-6200
(606) 408-6612
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
04143
KY
207Q00000X
Family Medicine Physician
04143
KY
208M00000X
Hospitalist Physician
Primary
04143
KY
Other
Enumeration date
04/23/2014
Last updated
12/14/2020
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