Healthcare Provider Details

I. General information

NPI: 1699813659
Provider Name (Legal Business Name): BLUEGRASS FERTILITY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1760 NICHOLASVILLE RD SUITE 501
LEXINGTON KY
40503-1471
US

IV. Provider business mailing address

2801 PALUMBO DR SUITE 101
LEXINGTON KY
40509-1317
US

V. Phone/Fax

Practice location:
  • Phone: 859-260-1515
  • Fax: 859-260-1804
Mailing address:
  • Phone: 859-260-1515
  • Fax: 859-260-1804

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number24600
License Number StateKY

VIII. Authorized Official

Name: JAMES W AKIN JR.
Title or Position: PRESIDENT
Credential: M.D.
Phone: 859-260-1515