Individual
ANTONIO LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1306 VERSAILLES RD STE 120, LEXINGTON, KY 40504-1795
(859) 259-2635
Mailing address
1306 VERSAILLES RD STE 120, LEXINGTON, KY 40504-1795
(859) 259-2635
(859) 254-7874
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
55764
KY
207R00000X
Internal Medicine Physician
R4554
KY
207R00000X
Internal Medicine Physician
TP290
KY
208000000X
Pediatrics Physician
TP290
KY
Other
Enumeration date
04/10/2017
Last updated
09/27/2022
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