Individual
PHILIP BRUCE LATHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
135 E MAXWELL ST, SUITE 200, LEXINGTON, KY 40508-2640
(859) 323-6211
Mailing address
138 LEADER AVE, LEXINGTON, KY 40508-3215
(859) 255-7910
(859) 257-7899
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
23186
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64231863
—
KY
Enumeration date
02/14/2007
Last updated
07/31/2014
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