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Individual

JEFFREY VIOLETTE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
1792 ALYSHEBA WAY, SUITE 150, LEXINGTON, KY 40509-2288
(859) 335-9041
(859) 335-9072
Mailing address
1792 ALYSHEBA WAY, SUITE 150, LEXINGTON, KY 40509-2288
(859) 335-9041
(859) 335-9072

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
02860
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000338914
ANTHEM
KY
05
010177618
VA
01
3000137
BWC
WV
05
3810004553
WV
01
50005452
PASSPORT
KY
05
64039522
KY
01
P00220271
RR-MEDICARE
KY
Enumeration date
07/28/2006
Last updated
05/04/2012
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