Provider Demographics
NPI:1043553878
Name:BAPTIST PHYSICIANS LEXINGTON, INC
Entity Type:Organization
Organization Name:BAPTIST PHYSICIANS LEXINGTON, INC
Other - Org Name:BAPTIST HEALTH SPECIALTY CLINIC (LONDON)
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:SUSAN
Authorized Official - Last Name:MOBLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-971-4652
Mailing Address - Street 1:100 PROFESSIONAL DR
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40741-8844
Mailing Address - Country:US
Mailing Address - Phone:606-330-4240
Mailing Address - Fax:606-330-4249
Practice Address - Street 1:100 PROFESSIONAL DR
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:KY
Practice Address - Zip Code:40741-8844
Practice Address - Country:US
Practice Address - Phone:606-330-4240
Practice Address - Fax:606-330-4249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-29
Last Update Date:2013-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY20547207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYK002402Medicare PIN