Individual
MAISON AUSTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1221 S BROADWAY, LEXINGTON, KY 40504-2701
(859) 258-4000
Mailing address
1086 FRANKLIN ST, JOHNSTOWN, PA 15905-4305
(814) 534-3745
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
05446
KY
207P00000X
Emergency Medicine Physician
OT020407
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100933690
—
KY
Enumeration date
06/23/2020
Last updated
10/23/2023
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