Healthcare Provider Details

I. General information

NPI: 1144663311
Provider Name (Legal Business Name): BAPTIST PHYSICIANS LEXINGTON, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2013
Last Update Date: 04/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

793 EASTERN BYP SUITE 201
RICHMOND KY
40475-2422
US

IV. Provider business mailing address

793 EASTERN BYP SUITE 201
RICHMOND KY
40475-2422
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 TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3006766
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number39044
License Number StateKY

VIII. Authorized Official

Name: CATHY SUSAN MOBLEY
Title or Position: VICE PRESIDENT
Credential:
Phone: 859-971-4652