Individual
CHARLES EDWARD ROSE III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1720 NICHOLASVILLE RD, STE 602, LEXINGTON, KY 40503-1404
(859) 277-4005
(859) 278-2507
Mailing address
1720 NICHOLASVILLE RD, STE 602, LEXINGTON, KY 40503-1404
(859) 277-4005
(859) 278-2507
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
40916
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100020800
—
KY
01
—
P00396857
RR MEDICARE
KY
Enumeration date
03/14/2007
Last updated
03/04/2008
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