Provider Demographics
NPI:1134142938
Name:UMANSKY, STEPHEN C (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:C
Last Name:UMANSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 BOB O LINK DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-3756
Mailing Address - Country:US
Mailing Address - Phone:859-258-8575
Mailing Address - Fax:859-258-8562
Practice Address - Street 1:700 BOB O LINK DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-3756
Practice Address - Country:US
Practice Address - Phone:859-258-8575
Practice Address - Fax:859-258-8562
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2014-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY37480207X00000X, 207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY4000501OtherMEDICARE LAB GRP
KY64052822Medicaid
KY37903705OtherMEDICAID LAB GRP
KYASC1019OtherMEDICARE ASC GROUP
KYCB5773OtherRR MEDICARE GRP
200044250OtherRR MEDICARE PIN
KY36000818OtherMEDICAID ASC GRP
KY0624121Medicare ID - Type Unspecified
H47100Medicare UPIN