Healthcare Provider Details

I. General information

NPI: 1538196480
Provider Name (Legal Business Name): DIAGNOSTIC HEALTH CENTER OF LEXINGTON, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 07/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 S MARTIN LUTHER KING BLVD
LEXINGTON KY
40508-2603
US

IV. Provider business mailing address

2764 PELHAM PKWY
PELHAM AL
35124-1702
US

V. Phone/Fax

Practice location:
  • Phone: 859-255-6640
  • Fax: 859-253-4786
Mailing address:
  • Phone: 205-685-5075
  • Fax: 205-994-7021

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MS. DONNA L BURCH
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 205-685-5075