Provider Demographics
NPI:1033261607
Name:LEXINGTON FOOT & ANKLE CENTER PSC
Entity Type:Organization
Organization Name:LEXINGTON FOOT & ANKLE CENTER PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:859-278-8855
Mailing Address - Street 1:103 DIAGNOSTIC DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:FRANKFORT
Mailing Address - State:KY
Mailing Address - Zip Code:40601-6524
Mailing Address - Country:US
Mailing Address - Phone:859-278-8855
Mailing Address - Fax:859-278-8856
Practice Address - Street 1:103 DIAGNOSTIC DR
Practice Address - Street 2:SUITE B
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40601-6524
Practice Address - Country:US
Practice Address - Phone:859-278-8855
Practice Address - Fax:859-278-8856
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LEXINGTON FOOT & ANKLE CENTER PSC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-17
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY00236213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1285781682OtherTOSHA NPI
KY1487681565OtherDR. ALLEN NPI
KY1659319721OtherDR. F NPI
KY1245256270OtherDR. H NPI
KY1821023250OtherDR. O NPI
KY78009958Medicaid
KY80000367Medicaid
KY80000417Medicaid
KY80002363Medicaid
KY0656901Medicare ID - Type UnspecifiedDR. ALLEN MC
KY80000417Medicaid
KYU85161Medicare UPIN
KYU96101Medicare UPIN
KYU69572Medicare UPIN
KY0655904Medicare ID - Type UnspecifiedTOSHA MEDICARE
KY1285781682OtherTOSHA NPI
KYP84800Medicare UPIN