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Individual

ADITYA BANSAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
110 CONN TER STE 550, LEXINGTON, KY 40508-3206
(859) 323-5867
(859) 323-8510
Mailing address
110 CONN TER STE 550, LEXINGTON, KY 40508-3206
(859) 218-2641

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
FL071
KY
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
FL071
KY

Other

Enumeration date
09/05/2023
Last updated
09/25/2023
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