Provider Demographics
NPI:1497728208
Name:LEXMEDICAL, INC
Entity Type:Organization
Organization Name:LEXMEDICAL, INC
Other - Org Name:DAVIDSON INTERNISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:G
Authorized Official - Last Name:MINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-243-4653
Mailing Address - Street 1:PO BOX 1537
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27293-1537
Mailing Address - Country:US
Mailing Address - Phone:336-243-4656
Mailing Address - Fax:336-243-4664
Practice Address - Street 1:105 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:NC
Practice Address - Zip Code:27292-6776
Practice Address - Country:US
Practice Address - Phone:336-236-4460
Practice Address - Fax:336-236-4462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-10
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0254QOtherBCBS GROUP NUMBER
NC690254QMedicaid
NCCG1312OtherRAILROAD MEDICARE
NC2329354OtherAETNA HMO
NC5640047OtherAETNA PPO
NC1123680002Medicare NSC
NC2319478CMedicare PIN