Provider Demographics
NPI:1710321625
Name:INFINITE MIND & BODY, LLC
Entity Type:Organization
Organization Name:INFINITE MIND & BODY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:T
Authorized Official - Last Name:HAMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-963-9012
Mailing Address - Street 1:2716 OLD ROSEBUD RD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-8008
Mailing Address - Country:US
Mailing Address - Phone:859-963-9012
Mailing Address - Fax:859-225-8446
Practice Address - Street 1:2716 OLD ROSEBUD RD
Practice Address - Street 2:SUITE 230
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-8008
Practice Address - Country:US
Practice Address - Phone:859-963-9012
Practice Address - Fax:859-225-8446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-22
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty