Individual
DAVID C. DOME
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
700 BOB O LINK DR, LEXINGTON, KY 40504-3756
(859) 258-8575
(859) 258-8562
Mailing address
700 BOB O LINK DR, LEXINGTON, KY 40504-3756
(859) 258-8575
(859) 258-8562
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
33958
KY
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
33958
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36000818
ASC MEDICAID GROUP
KY
01
—
37903705
MEDICAID LAB GROUP
KY
01
—
4000501
MEDICARE LAB GROUP
KY
05
—
64720873
—
KY
01
—
ASC1019
ASC MEDICARE GROUP
KY
01
—
CB5773
RR GROUP
KY
Enumeration date
07/04/2006
Last updated
11/02/2007
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