Healthcare Provider Details

I. General information

NPI: 1104223650
Provider Name (Legal Business Name): TOXPERTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2014
Last Update Date: 03/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 VENTERS LN SUITE 200
PIKEVILLE KY
41501-3016
US

IV. Provider business mailing address

400 VENTERS LN SUITE 200
PIKEVILLE KY
41501-3016
US

V. Phone/Fax

Practice location:
  • Phone: 606-653-1874
  • Fax:
Mailing address:
  • Phone: 606-653-1874
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MR. EUGENE SISCO III
Title or Position: MANAGING MEMBER
Credential:
Phone: 606-437-0097