Provider Demographics
NPI:1497758866
Name:DAVEY, WILLIAM PATRICK (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:PATRICK
Last Name:DAVEY
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 1:2424 HARRODSBURG RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-2106
Mailing Address - Country:US
Mailing Address - Phone:859-278-9492
Mailing Address - Fax:857-277-3027
Practice Address - Street 1:2424 HARRODSBURG RD
Practice Address - Street 2:SUITE 200
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-2106
Practice Address - Country:US
Practice Address - Phone:859-278-9492
Practice Address - Fax:857-277-3027
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-31
Last Update Date:2016-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ41528207N00000X, 207ND0101X
KY25734207N00000X, 207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
0300067OtherUNITED HEALTHCARE
C03014OtherCUMBERLAND HEALTHCARE
000000044794OtherANTHEM
KY010023345Medicare PIN
0300067OtherUNITED HEALTHCARE