Provider Demographics
NPI:1649781196
Name:LEXINGTON SURGICAL SPECIALISTS
Entity type:Organization
Organization Name:LEXINGTON SURGICAL SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:HILLARY
Authorized Official - Middle Name:
Authorized Official - Last Name:FUAGATE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-277-5711
Mailing Address - Street 1:1760 NICHOLASVILLE RD STE 202
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-1472
Mailing Address - Country:US
Mailing Address - Phone:859-277-5711
Mailing Address - Fax:859-967-1769
Practice Address - Street 1:1760 NICHOLASVILLE RD STE 202
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-1472
Practice Address - Country:US
Practice Address - Phone:859-277-5711
Practice Address - Fax:859-967-1769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-23
Last Update Date:2017-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY208200000X, 2086S0129X, 2086X0206X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Multi-Specialty
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty
No2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical OncologyGroup - Multi-Specialty