Healthcare Provider Details

I. General information

NPI: 1083809669
Provider Name (Legal Business Name): LEXINGTON HOSPITAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2007
Last Update Date: 01/13/2023
Certification Date: 01/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 WEST CHURCH STREET
LEXINGTON TN
38351-2014
US

IV. Provider business mailing address

200 WEST CHURCH STREET
LEXINGTON TN
38351-2014
US

V. Phone/Fax

Practice location:
  • Phone: 731-968-3646
  • Fax: 731-968-8113
Mailing address:
  • Phone: 731-968-3646
  • Fax: 731-968-8113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2085N0904X
TaxonomyNuclear Radiology Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: LARRY HENSON
Title or Position: RCD
Credential:
Phone: 336-944-6420