Basic Information
Provider Information
NPI: 1881913291
EntityType: 2
ReplacementNPI:  
OrganizationName: BAPTIST HEALTHCARE SYSTEM INC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: BAPTIST LABORIST SERVICE
OtherOrganizationType: 3
OtherLastName:  
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Mailing Information
Address1: 1740 NICHOLASVILLE RD
Address2:  
City: LEXINGTON
State: KY
PostalCode: 405031431
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 1740 NICHOLASVILLE RD
Address2:  
City: LEXINGTON
State: KY
PostalCode: 405031431
CountryCode: US
TelephoneNumber: 8592606970
FaxNumber: 8592606649
Other Information
ProviderEnumerationDate: 05/25/2010
LastUpdateDate: 06/28/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: SISSON
AuthorizedOfficialFirstName: WILLIAM
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: PRESIDENT
AuthorizedOfficialTelephone: 8592606100
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
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AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X  Y193400000X MULTIPLE SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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