Individual
LEONARD CURTIS FUGATE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
245 FOUNTAIN CT FL 1, LEXINGTON, KY 40509-2792
(859) 218-2626
(859) 257-3322
Mailing address
3209 SOLUTIONS CENTER, CHICAGO, IL 60677-0001
(502) 212-4759
(502) 471-2051
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA799
KY
363AM0700X
Medical Physician Assistant
PA799
KY
363AS0400X
Surgical Physician Assistant
PA799
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
95003877
—
KY
01
—
P00459649
RAILROAD MEDICARE
KY
Enumeration date
03/08/2006
Last updated
12/14/2022
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