Healthcare Provider Details

I. General information

NPI: 1518594159
Provider Name (Legal Business Name): XU XU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2020
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2195 HARRODSBURG RD
LEXINGTON KY
40504-3516
US

IV. Provider business mailing address

2195 HARRODSBURG RD STE 125
LEXINGTON KY
40504-3543
US

V. Phone/Fax

Practice location:
  • Phone: 859-323-5407
  • Fax:
Mailing address:
  • Phone: 859-323-2232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number61875
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: