Provider Demographics
NPI:1881804441
Name:SEREY, PATRICK J (MD)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:J
Last Name:SEREY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 RICHMOND RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40502-1204
Mailing Address - Country:US
Mailing Address - Phone:859-266-2101
Mailing Address - Fax:859-268-5636
Practice Address - Street 1:110 CONN TER
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40508-3206
Practice Address - Country:US
Practice Address - Phone:859-266-2101
Practice Address - Fax:859-268-5636
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2017-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY13948207XP3100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY13948OtherMEDICAL LICENSE
KY64139488Medicaid
C64658Medicare UPIN
KY64139488Medicare ID - Type Unspecified