Healthcare Provider Details

I. General information

NPI: 1356410732
Provider Name (Legal Business Name): WILLIAM JEFFERSON LESTER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 12/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2050 VERSAILLES RD
LEXINGTON KY
40504-1405
US

IV. Provider business mailing address

2050 VERSAILLES RD
LEXINGTON KY
40504-1405
US

V. Phone/Fax

Practice location:
  • Phone: 606-878-1219
  • Fax: 606-877-1195
Mailing address:
  • Phone: 606-878-1219
  • Fax: 606-877-1195

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number25618
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: