Provider Demographics
NPI:1376540476
Name:PAGE, GEORGE V (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:V
Last Name:PAGE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1760 NICHOLASVILLE RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-1471
Mailing Address - Country:US
Mailing Address - Phone:859-277-5711
Mailing Address - Fax:859-967-1769
Practice Address - Street 1:1760 NICHOLASVILLE RD
Practice Address - Street 2:SUITE 202
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-1471
Practice Address - Country:US
Practice Address - Phone:859-277-5711
Practice Address - Fax:859-967-1769
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2015-08-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY25506208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64255060Medicaid
KY25506OtherSTATE MEDICAL LICENSE
KYC72554Medicare UPIN
KY64255060Medicaid
KY0542804Medicare PIN