Healthcare Provider Details

I. General information

NPI: 1326280538
Provider Name (Legal Business Name): VPA PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2009
Last Update Date: 04/26/2024
Certification Date: 04/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2452 SIR BARTON WAY STE 303
LEXINGTON KY
40509-2549
US

IV. Provider business mailing address

PO BOX 639295 DEPT 93394
CINCINNATI OH
45263-9295
US

V. Phone/Fax

Practice location:
  • Phone: 800-759-7291
  • Fax: 989-667-8745
Mailing address:
  • Phone: 800-759-7291
  • Fax: 989-667-8745

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number720325
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code335V00000X
TaxonomyPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
License Number720325
License Number StateKY

VIII. Authorized Official

Name: DR. JEFFREY STEVENS
Title or Position: OWNER
Credential: DO
Phone: 248-824-6000