Provider Demographics
NPI:1902975527
Name:DRAKE, DAVID BARTLESON (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:BARTLESON
Last Name:DRAKE
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 1:740 SOUTH LIMESTONE KENTUCKY CLINIC 4TH FLOOR K454
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0001
Mailing Address - Country:US
Mailing Address - Phone:859-323-7506
Mailing Address - Fax:859-323-3823
Practice Address - Street 1:2195 HARRODSBURG RD FL 2
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-3516
Practice Address - Country:US
Practice Address - Phone:859-323-8082
Practice Address - Fax:859-257-5901
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY272232082S0105X, 2086S0105X, 2086S0122X
VA01010423482086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the Hand
No2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the Hand
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY27223OtherKY LICENSE
VA006900348Medicaid