Provider Demographics
NPI:1053542126
Name:NAZE, GARRETT SCOTT (DPT)
Entity type:Individual
Prefix:DR
First Name:GARRETT
Middle Name:SCOTT
Last Name:NAZE
Suffix:
Gender:M
Credentials:DPT
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Mailing Address - Street 1:740 S LIMESTONE STE E-214
Mailing Address - Street 2:UNIVERSITY OF KENTUCKY COLLEGE OF DENTISTRY
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0284
Mailing Address - Country:US
Mailing Address - Phone:859-323-5500
Mailing Address - Fax:859-257-5859
Practice Address - Street 1:740 S LIMESTONE STE E-214
Practice Address - Street 2:UNIVERSITY OF KENTUCKY COLLEGE OF DENTISTRY
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0284
Practice Address - Country:US
Practice Address - Phone:859-323-5500
Practice Address - Fax:859-257-5859
Is Sole Proprietor?:No
Enumeration Date:2009-08-06
Last Update Date:2024-06-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI11294024225100000X
NCP14525225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100349290Medicaid
KY7100349290Medicaid