Provider Demographics
NPI:1558654715
Name:LONDON-BOUNDS, TESSA (MD)
Entity type:Individual
Prefix:DR
First Name:TESSA
Middle Name:
Last Name:LONDON-BOUNDS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TESSA
Other - Middle Name:ELIZABETH
Other - Last Name:LONDON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:CARDIOTHORACIC SURGERY 740 S LIMESTONE SUITE A301
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0284
Mailing Address - Country:US
Mailing Address - Phone:859-323-6494
Mailing Address - Fax:859-257-4682
Practice Address - Street 1:KENTUCKY CLINIC 740 S LIMESTONE SUITE A301
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536
Practice Address - Country:US
Practice Address - Phone:859-323-6494
Practice Address - Fax:859-257-4682
Is Sole Proprietor?:No
Enumeration Date:2011-05-20
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY49171208G00000X
KYR2583208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No208600000XAllopathic & Osteopathic PhysiciansSurgery