Individual
DR. IMA MBODIE EBONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
740 S LIMESTONE KY CLINIC J401, LEXINGTON, KY 40536
(859) 323-5661
Mailing address
740 S LIMESTONE KY CLINIC J401, LEXINGTON, KY 40536-0284
(859) 323-5661
Taxonomy
Speciality
Code
Description
License number
State
2084N0600X
Clinical Neurophysiology Physician
Primary
51368
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
FL
Other
Enumeration date
03/24/2013
Last updated
05/02/2022
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