Provider Demographics
NPI:1063994382
Name:DUSSEAULT, SONYA K (DO)
Entity type:Individual
Prefix:DR
First Name:SONYA
Middle Name:K
Last Name:DUSSEAULT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:1221 S BROADWAY
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-2701
Mailing Address - Country:US
Mailing Address - Phone:859-258-6200
Mailing Address - Fax:859-258-6203
Practice Address - Street 1:100 N EAGLE CREEK DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-1805
Practice Address - Country:US
Practice Address - Phone:859-258-5027
Practice Address - Fax:859-258-5177
Is Sole Proprietor?:No
Enumeration Date:2018-09-04
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLUO6338207Q00000X
KY06084207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine