Individual
KRISTINE SONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
800 ROSE ST # M-53, LEXINGTON, KY 40536
(859) 323-2300
Mailing address
800 ROSE ST # M-53, LEXINGTON, KY 40536-0001
(859) 323-2300
(859) 323-2300
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
R4589
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
R4589
—
KY
Enumeration date
06/23/2014
Last updated
07/05/2018
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