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VICTOR R ANGELES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
908 WALLACE AVE, LEITCHFIELD, KY 42754-1479
(270) 230-0212
(270) 230-0104
Mailing address
908 WALLACE AVE, LEITCHFIELD, KY 42754-1479
(270) 230-0212
(270) 230-0104

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
37612
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000333566
ANTHEM
KY
01
2444879000
PASSPORT ADVANTAGE
KY
01
50003444
PASSPORT
KY
05
64057722
KY
Enumeration date
06/20/2005
Last updated
02/01/2012
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