Healthcare Provider Details

I. General information

NPI: 1306165527
Provider Name (Legal Business Name): BAPTIST PHYSICIANS LEXINGTON, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2010
Last Update Date: 06/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

166 PASADENA DR SUITE 100
LEXINGTON KY
40503-2973
US

IV. Provider business mailing address

PO BOX 910008
LEXINGTON KY
40591-0008
US

V. Phone/Fax

Practice location:
  • Phone: 859-278-0319
  • Fax: 859-277-9699
Mailing address:
  • Phone: 859-260-4385
  • Fax: 859-260-4386

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM SISSON
Title or Position: PRESIDENT
Credential:
Phone: 859-260-6100