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Individual

BRIAN GRACE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
639 N MULBERRY ST, ELIZABETHTOWN, KY 42701-1931
(270) 737-4600
(270) 737-1722
Mailing address
639 N MULBERRY ST, ELIZABETHTOWN, KY 42701-1931
(270) 737-4600
(270) 737-1722

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
38620
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6408257
KY
Enumeration date
06/17/2005
Last updated
03/19/2008
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