Individual
LOURENTE BACUS TIGAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
330 QUAIL CT, RUSSELL, KY 41169-1575
(606) 836-8303
Mailing address
330 QUAIL CT, RUSSELL, KY 41169-1575
(606) 836-8303
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
20101
KY
Other
Enumeration date
02/22/2018
Last updated
02/22/2018
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