Individual
DR. TIMOTHY R LAVENDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
108 N AUXIER AVE, PIKEVILLE, KY 41501-9045
(606) 432-9106
(606) 432-0967
Mailing address
108 N AUXIER AVE, PIKEVILLE, KY 41501-9045
(606) 432-9106
(606) 432-0967
Taxonomy
Speciality
Code
Description
License number
State
207NS0135X
Procedural Dermatology Physician
Primary
02627
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64005812
—
KY
Enumeration date
05/20/2006
Last updated
08/07/2017
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