Individual
DR. TINA DENISE FAWNS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2195 HARRODSBURG RD STE 125, LEXINGTON, KY 40504-3504
(859) 323-6371
(859) 323-6661
Mailing address
2195 HARRODSBURG RD, SUITE 125, LEXINGTON, KY 40504
(859) 323-6712
(859) 323-6661
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
37312
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2619152
—
OH
05
—
3810003773
—
WV
05
—
64068117
—
KY
Enumeration date
05/27/2006
Last updated
06/22/2017
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