1497966477 NPI number — LEXINGTON WOMENS HEALTH PLLC

Table of content: (NPI 1497966477)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497966477 NPI number — LEXINGTON WOMENS HEALTH PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LEXINGTON WOMENS HEALTH PLLC
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:
1497966477
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/14/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1720 NICHOLASVILLE RD
Provider Second Line Business Mailing Address:
SUITE 702
Provider Business Mailing Address City Name:
LEXINGTON
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40503-1489
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
859-264-8811
Provider Business Mailing Address Fax Number:
859-264-8822

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1720 NICHOLASVILLE RD.
Provider Second Line Business Practice Location Address:
SUITE 702
Provider Business Practice Location Address City Name:
LEXINGTON
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40503-1489
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-264-8811
Provider Business Practice Location Address Fax Number:
859-264-8822
Provider Enumeration Date:
05/24/2007

Additional Information

Authorized Official

Authorized Official Last Name:
FUSON
Authorized Official First Name:
JENNIFER
Authorized Official Middle Name:
A.
Authorized Official Title or Position:
M.D. / OWNER
Authorized Official Telephone Number:
859-264-8811

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207VG0400X , with the licence number: 34331 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207VM0101X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363A00000X , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363AM0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363L00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LW0102X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LX0001X , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 367A00000X , with the licence number: 1863M , 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)

  • Identifier: 7100219270 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7100648270 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7100225080 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7100227330 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7100644830 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7100225090 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7100227300 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7100225030 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




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