Provider Demographics
NPI:1003000316
Name:ALEXANDER J. TIKHTMAN, M.D., P.S.C.
Entity Type:Organization
Organization Name:ALEXANDER J. TIKHTMAN, M.D., P.S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:JACOB
Authorized Official - Last Name:TIKHTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-536-0676
Mailing Address - Street 1:1517 NICHOLASVILLE RD
Mailing Address - Street 2:SUITE 403
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-1429
Mailing Address - Country:US
Mailing Address - Phone:859-276-6168
Mailing Address - Fax:859-276-0850
Practice Address - Street 1:1517 NICHOLASVILLE RD
Practice Address - Street 2:SUITE 403
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-1429
Practice Address - Country:US
Practice Address - Phone:859-276-6168
Practice Address - Fax:859-276-0850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-29
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY277592084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1184668956OtherINDIVIDUAL NPI
KY64277593Medicaid
KY64277593Medicaid
KY0779601Medicare PIN