1134356124 NPI number — LYKINS SURGICAL ASSISTING, 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 1134356124 NPI number — LYKINS SURGICAL ASSISTING, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LYKINS SURGICAL ASSISTING, 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:
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:
1134356124
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/17/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 22184
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LEXINGTON
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40522-2184
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
502-454-7766
Provider Business Mailing Address Fax Number:
502-454-7788

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4119 BROWNS LN
Provider Second Line Business Practice Location Address:
STE 2B
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40220-1500
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-454-7766
Provider Business Practice Location Address Fax Number:
502-454-7788
Provider Enumeration Date:
06/17/2009

Additional Information

Authorized Official

Authorized Official Last Name:
SHY
Authorized Official First Name:
ALISON
Authorized Official Middle Name:
J
Authorized Official Title or Position:
BILLING MANAGER
Authorized Official Telephone Number:
502-454-7766

Provider Taxonomy Codes

  • Taxonomy code: 246ZS0410X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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