Healthcare Provider Details

I. General information

NPI: 1043583115
Provider Name (Legal Business Name): BAPTIST PHYSICIANS LEXINGTON, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2012
Last Update Date: 02/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1720 NICHOLASVILLE RD SUITE 703
LEXINGTON KY
40503-1404
US

IV. Provider business mailing address

PO BOX 910439
LEXINGTON KY
40591-0439
US

V. Phone/Fax

Practice location:
  • Phone: 859-260-6348
  • Fax: 859-260-4350
Mailing address:
  • Phone: 859-260-4385
  • Fax: 859-260-4386

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM SISSON
Title or Position: PRESIDENT
Credential:
Phone: 859-260-6104