Provider Demographics
NPI:1124021803
Name:LEUNG, PATRICK K (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:K
Last Name:LEUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1401 HARRODSBURG RD
Mailing Address - Street 2:STE C225
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-3751
Mailing Address - Country:US
Mailing Address - Phone:859-373-0700
Mailing Address - Fax:859-422-3994
Practice Address - Street 1:1401 HARRODSBURG RD
Practice Address - Street 2:STE C225
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-3751
Practice Address - Country:US
Practice Address - Phone:859-373-0700
Practice Address - Fax:859-422-3994
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-24
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY240122084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY130024465OtherRAILROAD MEDICARE
KY000000208943OtherANTHEM BC/BS
KY64240120Medicaid
KY0169Medicare PIN
KY1897601Medicare PIN
KY000000208943OtherANTHEM BC/BS