Idstein, Spencer Ryan

Idstein, Spencer Ryan is an individual health care provider with primary practice located at 6341 Meeting St Ste 102 , Prospect KY 40059-8731. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Idstein, Spencer Ryan can be contacted via phone (502) 566-0300.

Contact Information

Primary practice address
6341 Meeting St Ste 102 Prospect KY 40059-8731
Phone: (502) 566-0300
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 49531 Kentucky
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 49531 Kentucky

Profile Details

NPI number 1205194693
LBN Legal business name Idstein, Spencer Ryan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 24th, 2012
Last updated Dec 8th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205194693 NPPES
Kentucky MEDICAID 7100439060

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