Healthcare Provider Details

I. General information

NPI: 1508982166
Provider Name (Legal Business Name): CAMERON S SCHAEFFER MD PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 11/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1760 NICHOLASVILLE RD SUITE 601
LEXINGTON KY
40503-1471
US

IV. Provider business mailing address

1760 NICHOLASVILLE RD SUITE 601
LEXINGTON KY
40503-1471
US

V. Phone/Fax

Practice location:
  • Phone: 859-275-5437
  • Fax: 859-275-5434
Mailing address:
  • Phone: 859-275-5437
  • Fax: 859-275-5434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code2088P0231X
TaxonomyPediatric Urology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. CAMERON SHERWOOD SCHAEFFER
Title or Position: OWNER
Credential:
Phone: 859-275-5437