Individual
DR. RICKY D. ISERNHAGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
120 N EAGLE CREEK DR, STE 500, LEXINGTON, KY 40509-1827
(859) 263-3900
(859) 263-3757
Mailing address
120 N EAGLE CREEK DR, STE 500, LEXINGTON, KY 40509-1827
(859) 263-3900
(859) 263-3757
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
25118
KY
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
25118
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0095007000
—
WV
05
—
0678897
—
OH
05
—
64251184
—
KY
Enumeration date
06/15/2005
Last updated
05/08/2017
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