Provider Demographics
NPI:1184987844
Name:O'SHAUGHNESSY, MAUREEN (MD)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:
Last Name:O'SHAUGHNESSY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:740 SLIMESTONE STREET KENTUCKY CLINIC SUITE K401
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0284
Mailing Address - Country:US
Mailing Address - Phone:859-218-3055
Mailing Address - Fax:859-323-2412
Practice Address - Street 1:740 SLIMESTONE STREET KENTUCKY CLINIC SUITE K401
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536
Practice Address - Country:US
Practice Address - Phone:859-218-3055
Practice Address - Fax:859-323-2412
Is Sole Proprietor?:No
Enumeration Date:2012-06-19
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY51552207X00000X, 207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN200003449Medicare PIN