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Individual

MR. LEE W RICKETTS II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2600 GRIBBIN DR, LEXINGTON, KY 40517-4498
(859) 268-8190
(859) 268-9823
Mailing address
2600 GRIBBIN DR, LEXINGTON, KY 40517-4498
(859) 268-8190
(859) 268-9823

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
30881
KY
208000000X
Pediatrics Physician
30881
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000308817
ANTHEM
05
64308810
KY
Enumeration date
06/22/2006
Last updated
01/23/2018
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