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Organization

KENTUCKY DIABETES ENDOCRINOLOGY CENTER, PSC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LYLE CHRISTOPHER MYERS M.D. (CORPORATE PRESIDENT)
(859) 227-8015
Entity
Organization

Contact information

Practice address
417 E CAMBRIDGE LN, NICHOLASVILLE, KY 40356-8132
(859) 351-3801
Mailing address
417 E CAMBRIDGE LN, NICHOLASVILLE, KY 40356-8132
(859) 351-3801

Taxonomy

Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1408233
UMWA
01
208448
BLACK LUNG
05
659 282 36
KY
01
K008543
CHAMPUS
Enumeration date
12/14/2006
Last updated
01/07/2022
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