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General NPI Number Information
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NPI Number | 1306118617
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Entity Type | Organization
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Legal Business Name | LB HEALTH PSC
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Dates
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Enumeration Date | 02/01/2012
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Last Update Date | 05/17/2012
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Provider Practice Location Address
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Address Line | 1904 NICHOLASVILLE RD
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City | LEXINGTON
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State | KY
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Zip | 40503-2025
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Country | US
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Telephone | 859-576-0040
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Fax |
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Provider Business Mailing Address
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Address Line | 1904 NICHOLASVILLE RD
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City | LEXINGTON
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State | KY
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Zip | 40503-2025
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Country | US
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Telephone | 859-576-0040
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. LARRY C BURNS
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Credential | M.D
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Telephone | 859-576-0040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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