Provider Demographics
NPI:1700841715
Name:ABSHER, DALE R (MD)
Entity Type:Individual
Prefix:DR
First Name:DALE
Middle Name:R
Last Name:ABSHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1218 S BROADWAY
Mailing Address - Street 2:SUITE 310
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-2759
Mailing Address - Country:US
Mailing Address - Phone:859-219-0542
Mailing Address - Fax:859-219-9433
Practice Address - Street 1:1218 S BROADWAY
Practice Address - Street 2:SUITE 310
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-2759
Practice Address - Country:US
Practice Address - Phone:859-219-0542
Practice Address - Fax:859-219-9433
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY311622085R0204X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64311624Medicaid
0572010Medicare UPIN
G91190Medicare UPIN
0572110Medicare PIN
G91190Medicare UPIN
0674602Medicare ID - Type Unspecified
0723601Medicare ID - Type Unspecified
0581310Medicare ID - Type Unspecified
0571910Medicare ID - Type Unspecified
0571810Medicare ID - Type Unspecified
0581210Medicare ID - Type Unspecified
0946401Medicare ID - Type Unspecified
0950501Medicare ID - Type Unspecified
0572110Medicare PIN