Individual
MARK ILTIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2350 REGENCY RD STE A, LEXINGTON, KY 40503-2351
(859) 278-4960
(859) 278-0033
Mailing address
2350 REGENCY RD STE A, LEXINGTON, KY 40503-2351
(859) 278-4960
(859) 278-0033
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
05248
KY
Other
Enumeration date
05/15/2015
Last updated
06/02/2023
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