Provider Demographics
NPI:1053374082
Name:TOVAR, GETULIO VARGAS (MD)
Entity type:Individual
Prefix:DR
First Name:GETULIO
Middle Name:VARGAS
Last Name:TOVAR
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3175 CUSTER DR
Mailing Address - Street 2:SUITE #200
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40517-4023
Mailing Address - Country:US
Mailing Address - Phone:859-273-1288
Mailing Address - Fax:859-273-1278
Practice Address - Street 1:3175 CUSTER DR
Practice Address - Street 2:SUITE #200
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40517-4023
Practice Address - Country:US
Practice Address - Phone:859-273-1288
Practice Address - Fax:859-273-1278
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY184962084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64184963Medicaid
KY64184963Medicaid
KY0019503Medicare ID - Type Unspecified