Thomas L Broster, M.D.

Individual provider Active NPI Anesthesiology Physician · Lexington, KY

NPI 1053496331 · NPPES record last updated Mar 7, 2023

Key facts

NPI
1053496331
Entity type
Individual (NPI type 1)
Primary specialty
Anesthesiology Physician 207L00000X
License
25093 (KY)
Practice address
1740 Nicholasville Rd
Lexington, KY 40503-1431
Phone
(859) 260-6100
NPI assigned
Oct 26, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 25093 KY Yes

Addresses

Primary practice location

1740 Nicholasville Rd
Lexington, KY 40503-1431

Mailing address

425 Lewis Hargett Cir
Lexington, KY 40503-3590
Phone (859) 268-1030

Other identifiers

IdentifierTypeStateIssuer
64250939MedicaidKY

Other providers in Lexington, KY

All providers in Lexington, KY · Anesthesiology Physician in Kentucky

Sources for this page

Verify at the official NPI Registry.