Healthcare Provider Details

I. General information

NPI: 1629333125
Provider Name (Legal Business Name): BAPTIST PHYSICIANS LEXINGTON, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2012
Last Update Date: 08/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

349 BOGLE ST SUITE B
SOMERSET KY
42503-2895
US

IV. Provider business mailing address

349 BOGLE ST SUITE B
SOMERSET KY
42503-2895
US

V. Phone/Fax

Practice location:
  • Phone: 606-451-9448
  • Fax: 606-451-9540
Mailing address:
  • Phone: 606-451-9448
  • Fax: 606-451-9540

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
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MS. CATHY SUSAN MOBLEY
Title or Position: VICE PRESIDENT
Credential:
Phone: 859-260-4122