Healthcare Provider Details

I. General information

NPI: 1841861002
Provider Name (Legal Business Name): SURGICAL ASSOCIATES OF LEXINGTON PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2021
Last Update Date: 08/07/2021
Certification Date: 08/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

278 SOUTHLAND DR STE 140
LEXINGTON KY
40503-1900
US

IV. Provider business mailing address

278 SOUTHLAND DR STE 140
LEXINGTON KY
40503-1900
US

V. Phone/Fax

Practice location:
  • Phone: 859-771-1199
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: CHERYL REICHEL
Title or Position: BILLING MGR
Credential:
Phone: 859-771-1199