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Individual

WALTER A SHANK JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2101 NICHOLASVILLE RD, STE 106, LEXINGTON, KY 40503-2518
(859) 278-5926
(859) 276-3189
Mailing address
2101 NICHOLASVILLE RD, STE 106, LEXINGTON, KY 40503-2518
(859) 278-5926
(859) 276-3189

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
28899
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
64288996
KY
Enumeration date
07/18/2005
Last updated
07/08/2007
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