Provider Demographics
NPI:1801360243
Name:PETER TATE
Entity Type:Organization
Organization Name:PETER TATE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:TATE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-785-5141
Mailing Address - Street 1:1760 NICHOLASVILLE RD STE 601
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-1474
Mailing Address - Country:US
Mailing Address - Phone:859-785-5141
Mailing Address - Fax:859-221-8176
Practice Address - Street 1:1760 NICHOLASVILLE RD STE 601
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-1474
Practice Address - Country:US
Practice Address - Phone:859-785-5141
Practice Address - Fax:859-221-8176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-18
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical OncologyGroup - Single Specialty