Individual
DR. GARY JASPER MELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
520 VIOLET RD, CRITTENDEN, KY 41030-7480
(859) 428-1610
(859) 428-3923
Mailing address
2300 CHAMBER CENTER DR, SUITE 200, LAKESIDE PARK, KY 41017-1673
(859) 344-5555
(859) 428-3923
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20207
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2151193
—
OH
05
—
64202070
—
KY
Enumeration date
04/03/2006
Last updated
09/28/2015
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