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Individual

JOHN W. WEST

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1221 S BROADWAY, LEXINGTON, KY 40504-2701
(859) 258-4181
(859) 258-4058
Mailing address
1221 S BROADWAY, LEXINGTON, KY 40504-2701
(859) 258-4181
(859) 258-4058

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
26717
KY
2085R0204X
Vascular & Interventional Radiology Physician
26717
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
300025744
RR MEDICARE PIN
GA
01
37903705
MEDICAID LAB GRP
KY
05
64267172
KY
01
CB5773
RR MEDICARE GRP
GA
Enumeration date
07/25/2006
Last updated
05/20/2008
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