Provider Demographics
NPI:1437412723
Name:UNIVERS, JUNIOR (MD)
Entity Type:Individual
Prefix:
First Name:JUNIOR
Middle Name:
Last Name:UNIVERS
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 1:2350 REGENCY RD STE A
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-2351
Mailing Address - Country:US
Mailing Address - Phone:859-278-4960
Mailing Address - Fax:859-278-0033
Practice Address - Street 1:2350 REGENCY RD STE A
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-2351
Practice Address - Country:US
Practice Address - Phone:859-278-4960
Practice Address - Fax:859-277-2840
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-21
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY56493208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty