Healthcare Provider Details

I. General information

NPI: 1285685974
Provider Name (Legal Business Name): ASSOCIATED PHYSICIAN SERVICES OF LEXINGTON, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 S LIMESTONE
LEXINGTON KY
40508-3008
US

IV. Provider business mailing address

151 N EAGLE CREEK DR STE 100
LEXINGTON KY
40509-1889
US

V. Phone/Fax

Practice location:
  • Phone: 859-226-7000
  • Fax: 859-226-7266
Mailing address:
  • Phone: 859-263-4341
  • Fax: 859-263-7441

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. TONY G. SUDDUTH
Title or Position: CFO
Credential:
Phone: 859-226-7000