Healthcare Provider Details

I. General information

NPI: 1831974823
Provider Name (Legal Business Name): BAPTIST HEALTH MEDICAL GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2023
Last Update Date: 08/28/2023
Certification Date: 08/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1760 NICHOLASVILLE RD STE 101
LEXINGTON KY
40503-1410
US

IV. Provider business mailing address

1760 NICHOLASVILLE RD STE 101
LEXINGTON KY
40503-1410
US

V. Phone/Fax

Practice location:
  • Phone: 859-899-7950
  • Fax: 859-260-5150
Mailing address:
  • Phone: 859-899-7950
  • Fax: 859-260-5150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: DANYEL D CLAY
Title or Position: VICE PRESIDENT
Credential:
Phone: 502-253-4911