Provider Demographics
NPI:1386799864
Name:SWEET, LATONIA RICE
Entity type:Individual
Prefix:DR
First Name:LATONIA
Middle Name:RICE
Last Name:SWEET
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 BOONESBORO RD
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:KY
Mailing Address - Zip Code:40391-8816
Mailing Address - Country:US
Mailing Address - Phone:859-744-0067
Mailing Address - Fax:859-744-0042
Practice Address - Street 1:1520 BOONESBORO RD
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40391-8816
Practice Address - Country:US
Practice Address - Phone:859-744-0067
Practice Address - Fax:859-744-0042
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY394652084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY30615058Medicaid
KY30615058Medicaid
KYI42002Medicare UPIN
KY0332115Medicare ID - Type UnspecifiedMEDICARE
KY0331719Medicare ID - Type UnspecifiedMEDICARE