IndividualActive
Ian Provancha, MD
NPI 1700376530 · Vascular & Interventional Radiology Physician · Lexington, KY
Provider details
- NPI number
- 1700376530
- Entity type
- Individual
- Primary specialty
- Vascular & Interventional Radiology PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Student, Health Care
Practice location
800 Rose St
Lexington, KY 40536-7001
Phone: (859) 323-2222
Fax: (859) 323-5090
Approximate (ZIP-level) locationGet directions
Mailing address
475 Seaview Ave
Staten Island, NY 10305
Additional practice locations (1)
- 475 Seaview AveStaten Island, NY 10305Phone: (718) 226-8855
Registry dates
- Enumerated
- 2018-05-17
- Last updated
- 2024-06-06
- Certified
- 2024-06-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.