Basic Information
| Provider Information | |||||||||
| NPI: | 1477889079 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | BAPTIST PHYSICIANS LEXINGTON, INC | ||||||||
| LastName: | |||||||||
| FirstName: | |||||||||
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| OtherOrganizationName: | BAPTIST EXPRESS CARE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4071 TATES CREEK CENTRE DR | ||||||||
| Address2: | SUITE 202 | ||||||||
| City: | LEXINGTON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 405173062 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8592604390 | ||||||||
| FaxNumber: | 8592604399 | ||||||||
| Practice Location | |||||||||
| Address1: | 4071 TATES CREEK CENTRE DR | ||||||||
| Address2: | SUITE 202 | ||||||||
| City: | LEXINGTON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 405173062 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8592604390 | ||||||||
| FaxNumber: | 8592604399 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/02/2009 | ||||||||
| LastUpdateDate: | 02/05/2010 | ||||||||
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| AuthorizedOfficialLastName: | SISSON | ||||||||
| AuthorizedOfficialFirstName: | WILLIAMS | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8592606100 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261Q00000X | N | Ambulatory Health Care Facilities | Clinic/Center | 363L00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.