Individual
SHANNON A. ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
3084 LAKECREST CIR, LEXINGTON, KY 40513-1706
(859) 219-6440
(859) 219-6449
Mailing address
PO BOX 910670, LEXINGTON, KY 40591-0670
(859) 971-4685
(859) 971-4602
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
02918
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64108400
—
KY
Enumeration date
07/18/2006
Last updated
12/01/2020
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