Healthcare Provider Details

I. General information

NPI: 1093088163
Provider Name (Legal Business Name): BAPTIST PHYSICIANS LEXINGTON, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2012
Last Update Date: 07/31/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 NICHOLASVILLE RD SUITE 204
LEXINGTON KY
40503-2518
US

IV. Provider business mailing address

799 E BRANNON RD
NICHOLASVILLE KY
40356-6038
US

V. Phone/Fax

Practice location:
  • Phone: 859-260-4330
  • Fax: 859-260-4334
Mailing address:
  • Phone: 859-260-4330
  • Fax: 859-260-4334

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM SISSON
Title or Position: PRESIDENT
Credential:
Phone: 859-260-6104