Healthcare Provider Details

I. General information

NPI: 1396002473
Provider Name (Legal Business Name): POOLE AND THOMAS PEDIATRICS, PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2012
Last Update Date: 07/22/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2351 HUGUENARD DR SUITE 200
LEXINGTON KY
40503-3014
US

IV. Provider business mailing address

2351 HUGUENARD DR SUITE 200
LEXINGTON KY
40503-3014
US

V. Phone/Fax

Practice location:
  • Phone: 859-260-7700
  • Fax:
Mailing address:
  • Phone: 859-260-7700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MRS. LAURA R SANDEFUR
Title or Position: PRACTICE ADMINISTRATOR
Credential: RN, BSN
Phone: 859-402-1894