Individual
JULIE L. TUDOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C.
Contact information
Practice address
100 N EAGLE CREEK DR, LCE-1, LEXINGTON, KY 40509-1805
(859) 258-5102
(859) 258-5177
Mailing address
100 N EAGLE CREEK DR, LCE-1, LEXINGTON, KY 40509-1805
(859) 258-5102
(859) 258-5177
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA661
KY
363AM0700X
Medical Physician Assistant
PA661
KY
363AS0400X
Surgical Physician Assistant
PA661
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
95003299
—
KY
Enumeration date
06/16/2005
Last updated
04/03/2013
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