Provider Demographics
NPI:1316946932
Name:BARTEE, REBECCA DIANE (DO)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:DIANE
Last Name:BARTEE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 MCCANN DR
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:KY
Mailing Address - Zip Code:40391-1158
Mailing Address - Country:US
Mailing Address - Phone:859-737-9900
Mailing Address - Fax:859-737-0050
Practice Address - Street 1:225 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40391-7604
Practice Address - Country:US
Practice Address - Phone:859-737-9900
Practice Address - Fax:859-737-0050
Is Sole Proprietor?:No
Enumeration Date:2005-07-15
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY02529208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64025299Medicaid
KY1686701Medicare ID - Type Unspecified
KY64025299Medicaid