Provider Demographics
NPI:1760617385
Name:USERY, ANDREW RAY (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:RAY
Last Name:USERY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:110 VILLAGE PKWY
Mailing Address - Street 2:
Mailing Address - City:NICHOLASVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40356-2327
Mailing Address - Country:US
Mailing Address - Phone:859-887-8400
Mailing Address - Fax:859-885-8448
Practice Address - Street 1:110 VILLAGE PKWY
Practice Address - Street 2:
Practice Address - City:NICHOLASVILLE
Practice Address - State:KY
Practice Address - Zip Code:40356-2327
Practice Address - Country:US
Practice Address - Phone:859-887-8400
Practice Address - Fax:859-885-8448
Is Sole Proprietor?:No
Enumeration Date:2009-05-27
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY46323207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY0169Medicare PIN