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General NPI Number Information
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NPI Number | 1053664375
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Entity Type | Organization
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Legal Business Name | LEXINGTON FAMILY MEDICINE
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Dates
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Enumeration Date | 10/24/2012
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Last Update Date | 10/24/2012
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Provider Practice Location Address
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Address Line | 152 W TIVERTON WAY STE 160
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City | LEXINGTON
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State | KY
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Zip | 40503-4437
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Country | US
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Telephone | 859-402-2005
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Fax | 859-272-2414
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Provider Business Mailing Address
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Address Line | 152 W TIVERTON WAY STE 160
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City | LEXINGTON
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State | KY
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Zip | 40503-4437
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Country | US
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Telephone | 859-402-2005
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Fax | 859-272-2414
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Authorized Official
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Title or Position | OWNER
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Name | DR. KARLA GROVES
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Credential | MD
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Telephone | 859-402-2005
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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