Provider Demographics
NPI:1053664375
Name:LEXINGTON FAMILY MEDICINE
Entity Type:Organization
Organization Name:LEXINGTON FAMILY MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:GROVES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-402-2005
Mailing Address - Street 1:152 W TIVERTON WAY
Mailing Address - Street 2:STE 160
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-4437
Mailing Address - Country:US
Mailing Address - Phone:859-402-2005
Mailing Address - Fax:859-272-2414
Practice Address - Street 1:152 W TIVERTON WAY
Practice Address - Street 2:STE 160
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-4437
Practice Address - Country:US
Practice Address - Phone:859-402-2005
Practice Address - Fax:859-272-2414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-24
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care