1154434645 NPI number — JOHN L. VILLANO

Table of content: JOHN L. VILLANO (NPI 1154434645)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154434645 NPI number — JOHN L. VILLANO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VILLANO
Provider First Name:
JOHN
Provider Middle Name:
L.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1154434645
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/01/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
UK DIVISION OF MEDICAL ONCLOLGY
Provider Second Line Business Mailing Address:
800 ROSE STREET, CC401 ROACH BUILDING
Provider Business Mailing Address City Name:
LEXINGTON
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40536-0093
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
859-323-6522
Provider Business Mailing Address Fax Number:
859-257-3757

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
UK MEDICAL ONCOLOGY
Provider Second Line Business Practice Location Address:
800 ROSE STREET, CC401 ROACH BUILDING
Provider Business Practice Location Address City Name:
LEXINGTON
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40536-0093
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-323-6522
Provider Business Practice Location Address Fax Number:
859-257-3757
Provider Enumeration Date:
08/17/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RH0003X , with the licence number:  036103134 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RX0202X , with the licence number: 44900 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RH0003X , with the licence number: 44900 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 44900 . This is a "KY MEDICAL LICENSE" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".