Healthcare Provider Details

I. General information

NPI: 1437320611
Provider Name (Legal Business Name): BAPTIST PHYSICIANS LEXINGTON, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2008
Last Update Date: 06/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 PROVIDENCE WAY
NICHOLASVILLE KY
40356
US

IV. Provider business mailing address

100 PROVIDENCE WAY
NICHOLASVILLE KY
40356
US

V. Phone/Fax

Practice location:
  • Phone: 859-260-5370
  • Fax: 859-260-5379
Mailing address:
  • Phone: 859-260-5370
  • Fax: 859-260-5379

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

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