Healthcare Provider Details

I. General information

NPI: 1033046677
Provider Name (Legal Business Name): LEXINGTON RADIATION THERAPY CENTER, P.S.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 HARRODSBURG RD STE A100
LEXINGTON KY
40504-3746
US

IV. Provider business mailing address

1221 S BROADWAY
LEXINGTON KY
40504-2701
US

V. Phone/Fax

Practice location:
  • Phone: 859-258-6505
  • Fax: 859-258-6509
Mailing address:
  • Phone: 859-258-6200
  • Fax: 859-258-6203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

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