1013999473 NPI number — LEXINGTON PARK, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013999473 NPI number — LEXINGTON PARK, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LEXINGTON PARK, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1013999473
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/23/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3105 S MERIDIAN AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OKLAHOMA CITY
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
73119-1022
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
405-947-7700
Provider Business Mailing Address Fax Number:
405-947-7300

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
640 CLASSIC CT
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
MELBOURNE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32940-8279
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
321-872-2000
Provider Business Practice Location Address Fax Number:
321-872-2100
Provider Enumeration Date:
11/18/2005

Additional Information

Authorized Official

Authorized Official Last Name:
PETERS
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
LEE
Authorized Official Title or Position:
BILLING SUPERVISOR
Authorized Official Telephone Number:
405-947-7700

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  HHA299991743 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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