Organization
WESTSIDE PEDIATRICS PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. REBECCA G BOSOMWORTH M.D. (PRESIDENT)
(859) 277-3490
Entity
Organization
Contact information
Practice address
1701 ALEXANDRIA DR, LEXINGTON, KY 40504-3149
(859) 277-3490
(859) 278-5014
Mailing address
1701 ALEXANDRIA DR, LEXINGTON, KY 40504-3149
(859) 277-3490
(859) 278-5014
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
18125
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65941155
—
KY
Enumeration date
01/05/2007
Last updated
03/06/2014
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