Provider Demographics
NPI:1205808995
Name:AMERIPATH KENTUCKY INC
Entity type:Organization
Organization Name:AMERIPATH KENTUCKY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DARREN
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:WHEELER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-733-7866
Mailing Address - Street 1:14275 MIDWAY RD STE 400
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-3614
Mailing Address - Country:US
Mailing Address - Phone:214-932-8018
Mailing Address - Fax:610-271-4245
Practice Address - Street 1:2620 WILHITE DR
Practice Address - Street 2:SUITE 213
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-3385
Practice Address - Country:US
Practice Address - Phone:859-275-1922
Practice Address - Fax:859-225-3154
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMERIPATH INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-02-06
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY18D0323305207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810008434Medicaid
KY65939803Medicaid
WV3810008434Medicaid