Tackett, Reva Duff
Tackett, Reva Duff is an individual health care provider with primary practice located at 1720 Nicholasville Rd Ste 702 , Lexington KY 40503-1489. She recently has only one registered license in Allopathic & Osteopathic Physicians / Gynecology, which is considered as her primary health care specialty. Tackett, Reva Duff can be contacted via phone (859) 264-8811.Contact Information
Primary practice address
1720 Nicholasville Rd Ste 702
Lexington KY 40503-1489
Phone: (859) 264-8811
Fax: (859) 264-8822
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Gynecology | 207VG0400X | 20064 | Kentucky |
Profile Details
| NPI number | 1215916044 |
|---|---|
| LBN Legal business name | Tackett, Reva Duff |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 11th, 2006 |
| Last updated | Feb 3rd, 2022 - about 3 years ago |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1215916044 | NPPES |
| Kentucky | MEDICAID | 64220643 |
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