Provider Demographics
NPI:1750460036
Name:LEXINGTON SURGICAL SERVICES
Entity Type:Organization
Organization Name:LEXINGTON SURGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER PA, CSA
Authorized Official - Prefix:
Authorized Official - First Name:LAUREL
Authorized Official - Middle Name:J
Authorized Official - Last Name:SNELLING
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:859-396-3647
Mailing Address - Street 1:838 E HIGH ST
Mailing Address - Street 2:#288
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40502-2107
Mailing Address - Country:US
Mailing Address - Phone:859-396-3647
Mailing Address - Fax:859-268-8415
Practice Address - Street 1:838 E HIGH ST
Practice Address - Street 2:#288
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40502-2107
Practice Address - Country:US
Practice Address - Phone:859-396-3647
Practice Address - Fax:859-268-8415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPA313363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty