Provider Demographics
NPI:1235157645
Name:MCGUFFEY, MARY RACHEL (MD)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:RACHEL
Last Name:MCGUFFEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:RACHEL
Other - Last Name:CHAMBERLAIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:120 N EAGLE CREEK DR
Mailing Address - Street 2:SUITE 250
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-1827
Mailing Address - Country:US
Mailing Address - Phone:859-258-5141
Mailing Address - Fax:859-258-5168
Practice Address - Street 1:120 N EAGLE CREEK DR
Practice Address - Street 2:SUITE 250
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-1827
Practice Address - Country:US
Practice Address - Phone:859-258-5141
Practice Address - Fax:859-258-5168
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY36721208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY37903705OtherMEDICAID LAB GROUP
KY4000501OtherMEDICARE LAB GROUP
KY64034846Medicaid
CB5773OtherRR MEDICARE GROUP
KY0787004Medicare ID - Type Unspecified
KY64034846Medicaid