1063755130 NPI number — BAPTIST PHYSICIANS LEXINGTON, 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 1063755130 NPI number — BAPTIST PHYSICIANS LEXINGTON, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BAPTIST PHYSICIANS LEXINGTON, 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:
1063755130
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/01/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4071 TATES CREEK CENTRE DR
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
LEXINGTON
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40517-3062
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
859-624-6560
Provider Business Mailing Address Fax Number:
859-624-6569

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
789 EASTERN BYP
Provider Second Line Business Practice Location Address:
SUITE 16
Provider Business Practice Location Address City Name:
RICHMOND
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40475-2415
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-624-6560
Provider Business Practice Location Address Fax Number:
859-624-6569
Provider Enumeration Date:
03/27/2013

Additional Information

Authorized Official

Authorized Official Last Name:
MOBLEY
Authorized Official First Name:
CATHY
Authorized Official Middle Name:
SUSAN
Authorized Official Title or Position:
VICE PRESIDENT
Authorized Official Telephone Number:
859-260-4122

Provider Taxonomy Codes

  • Taxonomy code: 2084N0400X , with the licence number:  46246 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363A00000X , with the licence number: PA1177 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





Copyright © 2007-2025 www.npivalidator.com