Individual
DR. OWEN PATRICK MCGONIGLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3401 YORKSHIRE MEDICAL PARK, LEXINGTON, KY 40509-2513
(859) 263-5140
(859) 263-5141
Mailing address
3480 YORKSHIRE MEDICAL PARK, LEXINGTON, KY 40509-1886
(859) 263-5140
(859) 263-5141
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
244573
MA
207X00000X
Orthopaedic Surgery Physician
Primary
53083
KY
207X00000X
Orthopaedic Surgery Physician
TP543
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
53083
KY STATE LICENSE
KY
01
—
TP543
TEMPORARY KY STATE LICENSE
KY
Enumeration date
06/07/2010
Last updated
09/20/2019
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