1801113071 NPI number — LESTER S DUPLECHAN MD PLLC

Table of content: (NPI 1801113071)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801113071 NPI number — LESTER S DUPLECHAN MD PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LESTER S DUPLECHAN MD 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:
1801113071
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/24/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
350 THOMAS MORE PKWY
Provider Second Line Business Mailing Address:
STE 190
Provider Business Mailing Address City Name:
CRESTVIEW HILLS
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
41017-5465
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
859-341-4842
Provider Business Mailing Address Fax Number:
513-793-1032

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
350 THOMAS MORE PKWY
Provider Second Line Business Practice Location Address:
STE 190
Provider Business Practice Location Address City Name:
CRESTVIEW HILLS
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41017-5465
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-341-4842
Provider Business Practice Location Address Fax Number:
859-341-4845
Provider Enumeration Date:
04/28/2010

Additional Information

Authorized Official

Authorized Official Last Name:
DUPLECHAN
Authorized Official First Name:
LESTER
Authorized Official Middle Name:
S
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
859-341-4842

Provider Taxonomy Codes

  • Taxonomy code: 208100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 208VP0014X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 3074944 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: DR2194 . This is a "RR MEDICARE" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com