Provider Demographics
NPI:1801893730
Name:TOBIN, STUART (MD)
Entity type:Individual
Prefix:DR
First Name:STUART
Middle Name:
Last Name:TOBIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:800 ROSE ST., ROOM C225
Mailing Address - Street 2:UNIVERSITY OF KENTUCKY, DEPT. OF SURGERY
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0293
Mailing Address - Country:US
Mailing Address - Phone:859-323-6346
Mailing Address - Fax:859-323-6840
Practice Address - Street 1:740 S. LIMESTONE, RM L119
Practice Address - Street 2:UNIVERSITY OF KENTUCKY, KY CLINIC
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0284
Practice Address - Country:US
Practice Address - Phone:859-257-3253
Practice Address - Fax:859-323-6840
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2012-11-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY18026207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64180268Medicaid
KY1004902Medicare PIN
KY64180268Medicaid