Individual
KOSSA DIOMANDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 FUNKHOUSER BUILDING, LEXINGTON, KY 40506-0001
(859) 257-1754
Mailing address
3099 KIRKLEVINGTON DR APT 138, LEXINGTON, KY 40517-2480
(859) 494-5888
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MED-P
MT
Other
Enumeration date
05/06/2019
Last updated
08/28/2019
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