Healthcare Provider Details

I. General information

NPI: 1255604328
Provider Name (Legal Business Name): BAPTIST PHYSICIANS LEXINGTON, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2012
Last Update Date: 11/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

793 EASTERN BYP SUITE 106
RICHMOND KY
40475-2422
US

IV. Provider business mailing address

PO BOX 910670
LEXINGTON KY
40591-0670
US

V. Phone/Fax

Practice location:
  • Phone: 859-624-1826
  • Fax: 859-624-1744
Mailing address:
  • Phone: 859-971-4685
  • Fax: 859-971-4602

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: CATHY SUSAN MOBLEY
Title or Position: VICE PRESIDENT
Credential:
Phone: 859-260-6100