Healthcare Provider Details

I. General information

NPI: 1700919487
Provider Name (Legal Business Name): WILLIAM J LESTER, M.D., PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 02/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

181 OLD WHITLEY RD
LONDON KY
40744-8211
US

IV. Provider business mailing address

181 OLD WHITLEY RD
LONDON KY
40744-8211
US

V. Phone/Fax

Practice location:
  • Phone: 606-878-1219
  • Fax: 606-877-1195
Mailing address:
  • Phone: 606-878-1219
  • Fax: 606-877-1195

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number25618
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3529P
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3008495
License Number StateKY

VIII. Authorized Official

Name: RUTH ANNE COMBS
Title or Position: PRESIDENT
Credential: ARNP
Phone: 606-878-1219