Provider Demographics
NPI:1255604328
Name:BAPTIST PHYSICIANS LEXINGTON, INC
Entity type:Organization
Organization Name:BAPTIST PHYSICIANS LEXINGTON, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:SUSAN
Authorized Official - Last Name:MOBLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-260-6100
Mailing Address - Street 1:PO BOX 910670
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40591-0670
Mailing Address - Country:US
Mailing Address - Phone:859-971-4685
Mailing Address - Fax:859-971-4602
Practice Address - Street 1:793 EASTERN BYP
Practice Address - Street 2:SUITE 106
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-2422
Practice Address - Country:US
Practice Address - Phone:859-624-1826
Practice Address - Fax:859-624-1744
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BAPTIST PHYSICIANS LEXINGTON, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-02-20
Last Update Date:2013-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100255490Medicaid
KY7100146660Medicaid
KYK002402Medicare PIN