Healthcare Provider Details

I. General information

NPI: 1538194667
Provider Name (Legal Business Name): SAINT JOSEPH MEDICAL FOUNDATION, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 09/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 HARRODSBURG RD SUITE A440
LEXINGTON KY
40504-3751
US

IV. Provider business mailing address

1401 HARRODSBURG ROAD SUITE A440
LEXINGTON KY
40504
US

V. Phone/Fax

Practice location:
  • Phone: 859-967-5634
  • Fax: 859-967-5608
Mailing address:
  • Phone: 859-967-5634
  • Fax: 859-967-5608

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. GENE WOODS
Title or Position: CEO
Credential:
Phone: 859-313-1000