Healthcare Provider Details

I. General information

NPI: 1912270083
Provider Name (Legal Business Name): BAPTIST PHYSICIANS LEXINGTON, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2012
Last Update Date: 02/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1697 PEABODY WAY
LEXINGTON KY
40511-2146
US

IV. Provider business mailing address

PO BOX 910802
LEXINGTON KY
40591-0802
US

V. Phone/Fax

Practice location:
  • Phone: 859-226-2840
  • Fax: 859-226-2849
Mailing address:
  • Phone: 859-260-6901
  • Fax: 859-260-6606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MR. WILLIAM SISSON
Title or Position: PRESIDENT
Credential:
Phone: 859-260-6104