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Individual

DR. SUSAN M. LICHTENBERGER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
105 THOMPSON RD, RUSSELL, KY 41169-1645
(606) 833-8480
Mailing address
105 THOMPSON RD, RUSSELL, KY 41169-1645
(606) 833-8480

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
29626
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0918645
OH
05
64296262
KY
Enumeration date
01/19/2007
Last updated
08/27/2012
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