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General NPI Number Information
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NPI Number | 1710795299
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Entity Type | Organization
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Legal Business Name | LEXINGTON CLINIC CORP
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Dates
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Enumeration Date | 12/30/2024
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Last Update Date | 12/30/2024
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Provider Practice Location Address
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Address Line | 18688 JEB STUART HWY
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City | STUART
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State | VA
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Zip | 24171-1559
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Country | US
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Telephone | 336-944-6420
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 111
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City | STUART
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State | VA
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Zip | 24171-0111
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | RCD, AUTHORIZED OFFICIAL
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Name | LARRY HENSON
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Credential |
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Telephone | 336-944-6420
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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