Individual
GROVER MARK TUSSEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
107 DIAGNOSTIC DR, FRANKFORT, KY 40601-6524
(502) 875-9885
(502) 875-9882
Mailing address
PO BOX 1820, FRANKFORT, KY 40602-1820
(502) 226-3858
(502) 223-9829
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
37602
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64057623
—
KY
Enumeration date
08/15/2006
Last updated
09/23/2008
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