Healthcare Provider Details

I. General information

NPI: 1063777316
Provider Name (Legal Business Name): BAPTIST PHYSICIANS LEXINGTON, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2012
Last Update Date: 07/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3084 LAKECREST CIRCLE SUITE 100
LEXINGTON KY
40513
US

IV. Provider business mailing address

3084 LAKECREST CIRCLE SUITE 100
LEXINGTON KY
40513
US

V. Phone/Fax

Practice location:
  • Phone: 859-219-6440
  • Fax: 859-219-6449
Mailing address:
  • Phone: 859-219-6440
  • Fax: 859-219-6449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. CATHY SUSAN MOBLEY
Title or Position: VICE PRESIDENT
Credential:
Phone: 859-260-4122