Provider Demographics
NPI:1841308764
Name:LDE, MD, PLLC
Entity type:Organization
Organization Name:LDE, MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LENA
Authorized Official - Middle Name:D
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-224-3026
Mailing Address - Street 1:1001 MONARCH ST
Mailing Address - Street 2:STE 110
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40513-1848
Mailing Address - Country:US
Mailing Address - Phone:859-224-3026
Mailing Address - Fax:859-224-2685
Practice Address - Street 1:1001 MONARCH ST
Practice Address - Street 2:STE 110
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40513-1848
Practice Address - Country:US
Practice Address - Phone:859-224-3026
Practice Address - Fax:859-224-2685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty