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General NPI Number Information
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NPI Number | 1144360389
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Entity Type | Organization
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Legal Business Name | LEXINGTON FOOT & ANKLE CENTER PSC
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1138 LEXINGTON RD SUITE 210
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City | GEORGETOWN
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State | KY
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Zip | 40324-9672
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Country | US
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Telephone | 859-278-8855
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Fax | 859-278-8856
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Provider Business Mailing Address
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Address Line | 1138 LEXINGTON RD SUITE 210
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City | GEORGETOWN
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State | KY
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Zip | 40324-9672
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Country | US
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Telephone | 859-278-8855
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Fax | 859-278-8856
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Authorized Official
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Title or Position | CEO
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Name | MICHAEL ALLEN
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Credential | DPM
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Telephone | 859-278-8855
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 00236
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License Number State | KY
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