Healthcare Provider Details

I. General information

NPI: 1376884627
Provider Name (Legal Business Name): BAPTIST PHYSICIANS LEXINGTON, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2013
Last Update Date: 03/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1760 NICHOLASVILLE RD SUITE 302
LEXINGTON KY
40503-1471
US

IV. Provider business mailing address

1760 NICHOLASVILLE RD SUITE 302
LEXINGTON KY
40503-1471
US

V. Phone/Fax

Practice location:
  • Phone: 859-260-2766
  • Fax: 859-260-2767
Mailing address:
  • Phone: 859-260-2766
  • Fax: 859-260-2767

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: SUSAN MOBLEY
Title or Position: VICE PRESIDENT
Credential:
Phone: 859-971-4652