Healthcare Provider Details

I. General information

NPI: 1316385842
Provider Name (Legal Business Name): BAPTIST PHYSICIANS LEXINGTON, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2013
Last Update Date: 09/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 BULLION BLVD
WINCHESTER KY
40391-2933
US

IV. Provider business mailing address

4071 TATES CREEK CENTRE DR SUITE 202
LEXINGTON KY
40517-3062
US

V. Phone/Fax

Practice location:
  • Phone: 859-745-7700
  • Fax: 859-745-7733
Mailing address:
  • Phone: 859-745-7700
  • Fax: 859-745-7733

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number3004978
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number21227
License Number StateKY

VIII. Authorized Official

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