Healthcare Provider Details

I. General information

NPI: 1326508524
Provider Name (Legal Business Name): CHARLES-ANTOINE A MECHAS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2019
Last Update Date: 06/30/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 E MAXWELL ST STE 201
LEXINGTON KY
40508-2678
US

IV. Provider business mailing address

125 E MAXWELL ST STE 201
LEXINGTON KY
40508-2678
US

V. Phone/Fax

Practice location:
  • Phone: 859-323-5533
  • Fax: 859-257-2816
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number60677
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number76505
License Number StateMN
# 3
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number60677
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: