Healthcare Provider Details

I. General information

NPI: 1578025029
Provider Name (Legal Business Name): NEW LEXINGTON CLINIC, PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2019
Last Update Date: 04/08/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1207 S BROADWAY
LEXINGTON KY
40504-2701
US

IV. Provider business mailing address

1221 S BROADWAY
LEXINGTON KY
40504-2701
US

V. Phone/Fax

Practice location:
  • Phone: 859-258-8519
  • Fax: 859-258-8592
Mailing address:
  • Phone: 859-258-6091
  • Fax: 859-258-4161

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: JASON LADD
Title or Position: COF
Credential:
Phone: 859-258-4116