Provider Demographics
NPI:1891865952
Name:CHEST MEDICINE ASSOCIATES P.S.C.
Entity Type:Organization
Organization Name:CHEST MEDICINE ASSOCIATES P.S.C.
Other - Org Name:SLEEP MEDICINE SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:O
Authorized Official - Last Name:LACY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-454-0269
Mailing Address - Street 1:3430 NEWBURG RD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40218-2497
Mailing Address - Country:US
Mailing Address - Phone:502-238-3178
Mailing Address - Fax:502-238-3653
Practice Address - Street 1:4606 GREENWOOD RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40258-3726
Practice Address - Country:US
Practice Address - Phone:502-937-2209
Practice Address - Fax:502-933-8714
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY65934184Medicaid
KY1052030OtherPASSPORT
KY1052030OtherPASSPORT