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Individual

DANIELLE DETELICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
740 S LIMESTONE STE L119, LEXINGTON, KY 40536-1552
(859) 257-3253
(859) 323-1203
Mailing address
740 S LIMESTONE STE L119, LEXINGTON, KY 40536-0001
(859) 257-3253
(859) 323-1203

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
260094
MA
2086S0102X
Surgical Critical Care Physician
Primary
58217
KY

Other

Enumeration date
06/03/2014
Last updated
07/14/2023
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