Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Kyeongtak Song, PHD, ATC

Individual provider Athletic Trainer · NPI 1053089482

Dr. Kyeongtak Song, PHD, ATC is an Athletic Trainer in Lexington, Kentucky. Registered with an NPI since 2021.

In the registry since
2021
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.

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Practice location Address checks out

720 Sports Center Dr
Lexington, KY 40506-0001
Phone: (859) 323-9850
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X

Record details

NPI number1053089482
Entity typeIndividual (Type 1)
GenderMale
Credentials PHD , ATC
Sole proprietorNo
NPI enumeratedAugust 31, 2021
Last updated in NPPESAugust 31, 2021
Certification dateAugust 31, 2021

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