1609939032 NPI number — LEXINGTON FOOT AND ANKLE CENTER PSC

Table of content: (NPI 1609939032)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609939032 NPI number — LEXINGTON FOOT AND ANKLE CENTER PSC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LEXINGTON FOOT AND ANKLE CENTER PSC
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:
1609939032
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/28/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1401 HARRODSBURG RD
Provider Second Line Business Mailing Address:
C115
Provider Business Mailing Address City Name:
LEXINGTON
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40504-3751
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
859-278-8855
Provider Business Mailing Address Fax Number:
859-278-8856

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1401 HARRODSBURG RD
Provider Second Line Business Practice Location Address:
C115
Provider Business Practice Location Address City Name:
LEXINGTON
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40504-3751
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-278-8855
Provider Business Practice Location Address Fax Number:
859-278-8856
Provider Enumeration Date:
12/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ALLEN
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
C
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
859-278-8855

Provider Taxonomy Codes

  • Taxonomy code: 213ES0103X , with the licence number:  213ES0103X , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0000001164048 . This is a "CHA DR. ALLEN" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 000000188181 . This is a "ANTHEM DR. ALLEN" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 80002363 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: CH6950 . This is a "RRMC GROUP" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 480033145 . This is a "RRMC DR. ALLEN" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 5710659 . This is a "FIRST HEALTH DR. FINE" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 80000417 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2700180 . This is a "UHC DR. HARROD" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 7100003410 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1150286 . This is a "PASSPORT DR. ALLEN" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 80900061 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000491228 . This is a "ANTHEM DR. FINE" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 7173811 . This is a "AETNA DR. FINE" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 90003138 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




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