Provider Demographics
NPI:1609939032
Name:LEXINGTON FOOT AND ANKLE CENTER PSC
Entity Type:Organization
Organization Name:LEXINGTON FOOT AND ANKLE CENTER PSC
Other - Org Name:MICHAEL C ALLEN PSC
Other - Org Type:Former Legal Business Name
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 1:1401 HARRODSBURG RD
Mailing Address - Street 2:C115
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-3751
Mailing Address - Country:US
Mailing Address - Phone:859-278-8855
Mailing Address - Fax:859-278-8856
Practice Address - Street 1:1401 HARRODSBURG RD
Practice Address - Street 2:C115
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-3751
Practice Address - Country:US
Practice Address - Phone:859-278-8855
Practice Address - Fax:859-278-8856
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2011-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY213ES0103X213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY0000001164048OtherCHA DR. ALLEN
KY000000188181OtherANTHEM DR. ALLEN
KY80002363Medicaid
KYCH6950OtherRRMC GROUP
KY480033145OtherRRMC DR. ALLEN
KY5710659OtherFIRST HEALTH DR. FINE
KY80000417Medicaid
KY2700180OtherUHC DR. HARROD
KY7100003410Medicaid
KY1150286OtherPASSPORT DR. ALLEN
KY80900061Medicaid
KY000000491228OtherANTHEM DR. FINE
KY7173811OtherAETNA DR. FINE
KY90003138Medicaid
KY000000188181OtherANTHEM DR. ALLEN
KY6569Medicare ID - Type UnspecifiedLFAAC MC GROUP
KY480033145OtherRRMC DR. ALLEN
KY1150286OtherPASSPORT DR. ALLEN