LEXINGTON FOOT & ANKLE CENTER PSC

Provider Demographics

• NPI: 1336291624
• Name: LEXINGTON FOOT & ANKLE CENTER PSC
• Entity Type: Organization
• Organization Name: LEXINGTON FOOT & ANKLE CENTER PSC
• Authorized Official - Title/Position: CEO
• Authorized Official - First Name: MICHAEL
• Authorized Official - Middle Name: C
• Authorized Official - Last Name: ALLEN
• Authorized Official - Credentials: DPM
• Authorized Official - Phone: 859-278-8855
• Mailing Address - Street 1: 805 ALEXA DR
• Mailing Address - Street 2: SUITE C
• Mailing Address - City: MT STERLING
• Mailing Address - State: KY
• Mailing Address - Zip Code: 40353-1000
• Mailing Address - Country: US
• Mailing Address - Phone: 859-278-8855
• Mailing Address - Fax: 859-278-8856
• Practice Address - Street 1: 805 ALEXA DR
• Practice Address - Street 2: SUITE C
• Practice Address - City: MT STERLING
• Practice Address - State: KY
• Practice Address - Zip Code: 40353-1000
• Practice Address - Country: US
• Practice Address - Phone: 859-278-8855
• Practice Address - Fax: 859-278-8856
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2007-01-17
• Last Update Date: 2020-08-22

Provider Licenses

State	License ID	Taxonomies
KY	00236	213ES0103X

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	213ES0103X	Podiatric Medicine & Surgery Service Providers	Podiatrist	Foot & Ankle Surgery	Group - Single Specialty

Provider Identifiers

State	Identifier ID	ID Type	Issuer
KY	80000367	Medicaid
KY	80900061	Medicaid
	1821023250	Other	DR. O NPI
KY	78009958	Medicaid
KY	80000417	Medicaid
	1659319721	Other	DR. F NPI
KY	80002363	Medicaid
	1245256270	Other	DR. H NPI
	1285781682	Other	TOSHA NPI
	1487681565	Other	DR. A NPI
KY	0655904	Medicare ID - Type Unspecified	TOSHA MC
KY	80002363	Medicaid
KY	U85161	Medicare UPIN
KY	80900061	Medicaid
KY	0656907	Medicare ID - Type Unspecified	DR. H MC
KY	78009958	Medicaid
KY	80000417	Medicaid
	1245256270	Other	DR. H NPI
KY	0656901	Medicare ID - Type Unspecified	DR. A MC