Basic Information
| Provider Information | |||||||||
| NPI: | 1851536304 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BAPTIST PHYSICIANS LEXINGTON, INC. | ||||||||
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| OtherOrganizationName: | BAPTIST NEUROLOGY CONSULTANTS | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4071 TATES CREEK CENTRE DRIVE | ||||||||
| Address2: | SUITE 202 | ||||||||
| City: | LEXINGTON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 40517 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8592604385 | ||||||||
| FaxNumber: | 8592604386 | ||||||||
| Practice Location | |||||||||
| Address1: | 1775 ALYSHEBA WAY | ||||||||
| Address2: | SUITE 160 | ||||||||
| City: | LEXINGTON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 40509 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8592604390 | ||||||||
| FaxNumber: | 8592604399 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/12/2008 | ||||||||
| LastUpdateDate: | 04/20/2010 | ||||||||
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| AuthorizedOfficialLastName: | SISSON | ||||||||
| AuthorizedOfficialFirstName: | WILLIAM | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 8592606100 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | BAPTIST PHYSICIANS LEXINGTON, INC. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0400X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
No ID Information.