Healthcare Provider Details

I. General information

NPI: 1013477579
Provider Name (Legal Business Name): MATTHEW EARL EADS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2019
Last Update Date: 08/15/2025
Certification Date: 08/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

216 FOUNTAIN CT STE 250
LEXINGTON KY
40509-2510
US

IV. Provider business mailing address

216 FOUNTAIN CT STE 250
LEXINGTON KY
40509-2510
US

V. Phone/Fax

Practice location:
  • Phone: 859-276-5008
  • Fax: 859-278-6401
Mailing address:
  • Phone: 859-276-5008
  • Fax: 859-278-6401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License NumberTP604
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: