Healthcare Provider Details

I. General information

NPI: 1710115621
Provider Name (Legal Business Name): BAPTIST HEALTH RICHMOND, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2009
Last Update Date: 08/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

793 EASTERN BYPASS SUITE 201
RICHMOND KY
40475-2440
US

IV. Provider business mailing address

P.O. BOX 34166
LEXINGTON KY
40588-4166
US

V. Phone/Fax

Practice location:
  • Phone: 859-624-6560
  • Fax: 859-624-6569
Mailing address:
  • Phone: 859-624-6560
  • Fax: 859-624-6569

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: PAT OLDS
Title or Position: VP SUPPORT SVC.
Credential:
Phone: 859-625-3795