Individual
REBECCA LYNN GAYHEART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C.
Contact information
Practice address
3581 HARRODSBURG RD, LEXINGTON, KY 40513-1140
(859) 313-6200
(859) 447-8936
Mailing address
PO BOX 936, LONDON, KY 40743-0936
(606) 330-7835
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA451
KY
363AM0700X
Medical Physician Assistant
PA451
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36000818
ASC MEDICAID GROUP
KY
01
—
37903705
MEDICAID LAB GROUP
KY
01
—
4000501
MEDICARE LAB GROUP
KY
05
—
95001657
—
KY
01
—
970018782
RR MEDICARE PIN NO
KY
01
—
ASC1019
ASC MEDICARE GROUP
KY
01
—
CB5773
RR MEDICARE GROUP
KY
Enumeration date
10/05/2006
Last updated
12/04/2023
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