Provider Demographics
NPI:1154434645
Name:VILLANO, JOHN L
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:L
Last Name:VILLANO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UK DIVISION OF MEDICAL ONCLOLGY
Mailing Address - Street 2:800 ROSE STREET, CC401 ROACH BUILDING
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0093
Mailing Address - Country:US
Mailing Address - Phone:859-323-6522
Mailing Address - Fax:859-257-3757
Practice Address - Street 1:UK MEDICAL ONCOLOGY
Practice Address - Street 2:800 ROSE STREET, CC401 ROACH BUILDING
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0093
Practice Address - Country:US
Practice Address - Phone:859-323-6522
Practice Address - Fax:859-257-3757
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036103134207RH0003X
KY44900207RX0202X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY44900OtherKY MEDICAL LICENSE
K25403Medicare ID - Type Unspecified
KY44900OtherKY MEDICAL LICENSE