Individual
DR. NICOLA JABBOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
3470 BLAZER PKWY STE 350, LEXINGTON, KY 40509-2713
(859) 629-7110
(859) 543-1989
Mailing address
PO BOX 936, LONDON, KY 40743-0936
(606) 330-7835
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
43211
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000864630
ANTHEM BLUE CROSS AND BLUE SHIELD
—
05
—
7100126710
—
KY
01
—
CS1424500286
HUMANA CARESOURCE
—
Enumeration date
06/16/2007
Last updated
01/11/2024
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