Provider Demographics
NPI:1700919487
Name:WILLIAM J LESTER, M.D., PSC
Entity type:Organization
Organization Name:WILLIAM J LESTER, M.D., PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:COMBS
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:606-878-1219
Mailing Address - Street 1:181 OLD WHITLEY RD
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40744-8211
Mailing Address - Country:US
Mailing Address - Phone:606-878-1219
Mailing Address - Fax:606-877-1195
Practice Address - Street 1:181 OLD WHITLEY RD
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:KY
Practice Address - Zip Code:40744-8211
Practice Address - Country:US
Practice Address - Phone:606-878-1219
Practice Address - Fax:606-877-1195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2018-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3529P363LF0000X
KY3008495363LF0000X
KY25618208100000X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7017Medicare PIN