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Individual

DR. ANN N. QUACKENBUSH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1162 LEXINGTON RD, GEORGETOWN, KY 40324-9330
(502) 863-6426
Mailing address
137 BELVEDERE LN, GEORGETOWN, KY 40324-9437

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
33064
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000065120
ANTHEM BLUE CROSS
KY
01
1200489
UNITED HEALTH CARE
KY
01
5843767
AETNA
KY
01
611215814
BLUEGRASS FAMILY HEALTH
KY
05
64330640
KY
Enumeration date
08/31/2006
Last updated
04/16/2021
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