Provider Demographics
NPI:1295159622
Name:CHAFFINS, MARY LOUISE
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:LOUISE
Last Name:CHAFFINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 MOORE DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-2932
Mailing Address - Country:US
Mailing Address - Phone:859-276-1288
Mailing Address - Fax:
Practice Address - Street 1:160 MOORE DR
Practice Address - Street 2:SUITE 201
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-2932
Practice Address - Country:US
Practice Address - Phone:859-276-1288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-05
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171000000XOther Service ProvidersMilitary Health Care Provider