Provider Demographics
NPI:1881776771
Name:LEXINGTON INTERNAL MEDICINE CLINIC, PA
Entity type:Organization
Organization Name:LEXINGTON INTERNAL MEDICINE CLINIC, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:F
Authorized Official - Last Name:FLETCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-249-7051
Mailing Address - Street 1:PO BOX 1946
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27293
Mailing Address - Country:US
Mailing Address - Phone:336-249-7051
Mailing Address - Fax:336-248-2294
Practice Address - Street 1:901 E CENTER ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:NC
Practice Address - Zip Code:27292-4403
Practice Address - Country:US
Practice Address - Phone:336-249-7051
Practice Address - Fax:336-248-2294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2016-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC22543207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC02012OtherBCBS
NC8902012Medicaid