Basic Information
| Provider Information | |||||||||
| NPI: | 1629236930 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BAPTIST PHYSICIANS LEXINGTON | ||||||||
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| OtherOrganizationName: | BAPTIST GYN - ONCOLOGY SERVICE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1780 NICHOLASVILLE RD | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | LEXINGTON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 405031400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8592782671 | ||||||||
| FaxNumber: | 8592785978 | ||||||||
| Practice Location | |||||||||
| Address1: | 1780 NICHOLASVILLE RD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | LEXINGTON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 405031400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8592782671 | ||||||||
| FaxNumber: | 8592785978 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/23/2008 | ||||||||
| LastUpdateDate: | 12/05/2011 | ||||||||
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| AuthorizedOfficialLastName: | SISSON | ||||||||
| AuthorizedOfficialFirstName: | WILLIAM | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 8592606100 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RX0202X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Medical Oncology | 363L00000X | N | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 207VX0201X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Gynecologic Oncology |
No ID Information.