Provider Demographics
NPI:1245761964
Name:CHOW, ZETA
Entity Type:Individual
Prefix:
First Name:ZETA
Middle Name:
Last Name:CHOW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 ROSE ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0293
Mailing Address - Country:US
Mailing Address - Phone:859-323-6486
Mailing Address - Fax:
Practice Address - Street 1:800 ROSE ST
Practice Address - Street 2:C-246
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536
Practice Address - Country:US
Practice Address - Phone:859-323-6162
Practice Address - Fax:859-257-8934
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-23
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR4626208600000X
KYR46482085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
No208600000XAllopathic & Osteopathic PhysiciansSurgery