Provider Demographics
NPI:1588802946
Name:MCTIGUE, SEAN M (MD)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:M
Last Name:MCTIGUE
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:UK DEPARTMENT OF PEDIATRICS
Mailing Address - Street 2:800 ROSE STREET, MS-465
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0001
Mailing Address - Country:US
Mailing Address - Phone:859-323-2983
Mailing Address - Fax:
Practice Address - Street 1:UK DEPARTMENT OF PEDIATRICS
Practice Address - Street 2:800 ROSE STREET, MS-465
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0001
Practice Address - Country:US
Practice Address - Phone:859-323-2983
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-22
Last Update Date:2015-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY46214207RI0200X, 2080P0208X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No208000000XAllopathic & Osteopathic PhysiciansPediatrics