Provider Demographics
NPI:1922727676
Name:COMMONWEALTH MEDICAL PARTNERS INC
Entity Type:Organization
Organization Name:COMMONWEALTH MEDICAL PARTNERS INC
Other - Org Name:COMMONWEALTH MEDICAL PARTNERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:NELSON
Authorized Official - Last Name:CONRAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-494-9072
Mailing Address - Street 1:1152 IRON LACE CT
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-2343
Mailing Address - Country:US
Mailing Address - Phone:859-494-9072
Mailing Address - Fax:859-269-0948
Practice Address - Street 1:168 E REYNOLDS RD STE 110
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40517-1242
Practice Address - Country:US
Practice Address - Phone:859-494-9072
Practice Address - Fax:269-094-8859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-25
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty