Healthcare Provider Details
I. General information
NPI: 1932451085
Provider Name (Legal Business Name): BAPTIST PHYSICIANS LEXNGTON, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/12/2012
Last Update Date: 10/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1780 NICHOLASVILLE RD SUITE 403
LEXINGTON KY
40503-1400
US
IV. Provider business mailing address
1780 NICHOLASVILLE RD SUITE 403
LEXINGTON KY
40503-1400
US
V. Phone/Fax
- Phone: 859-260-2580
- Fax: 859-260-2585
- Phone: 859-260-2580
- Fax: 859-260-2585
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
CATHY
SUSAN
MOBLEY
Title or Position: VICE PRESIDENT
Credential:
Phone: 859-260-4122