Individual
IVO O BESONG MANGEB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1218 S BROADWAY STE 310, LEXINGTON, KY 40504-2759
(859) 219-0542
(859) 219-9433
Mailing address
1218 S BROADWAY STE 310, LEXINGTON, KY 40504-2759
(859) 219-0542
(859) 219-9433
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
0101282615
VA
2085R0202X
Diagnostic Radiology Physician
D89678
MD
2085R0202X
Diagnostic Radiology Physician
TP355
KY
Other
Enumeration date
04/01/2015
Last updated
07/12/2024
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