Individual
JOHN G VANSAVAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1029 MEDICAL CENTER CIR STE 408, MAYFIELD, KY 42066-1189
(270) 251-4060
(270) 251-4061
Mailing address
1029 MEDICAL CENTER CIRCLE, SUITE 408, MAYFIELD, KY 42066-1189
(270) 251-4060
(270) 251-4061
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
14153R
LA
208800000X
Urology Physician
Primary
32546
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1189413
—
LA
01
—
340019044
RAILROAD MEDICARE
LA
Enumeration date
06/20/2005
Last updated
07/21/2022
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