Healthcare Provider Details

I. General information

NPI: 1699048769
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

1760 NICHOLASVILLE RD SUITE 301
LEXINGTON KY
40503-1471
US

IV. Provider business mailing address

1760 NICHOLASVILLE RD SUITE 301
LEXINGTON KY
40503-1471
US

V. Phone/Fax

Practice location:
  • Phone: 859-277-6143
  • Fax: 859-277-8659
Mailing address:
  • Phone: 859-277-6143
  • Fax: 859-277-8659

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number State

VIII. Authorized Official

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