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Specialty details in registry · Lexington, KY

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At a glance

1795 Alysheba Way Ste 1103, Lexington, KY 40509-2282

NPPES record updated Jun 8, 2016. Public records can lag behind changes at a practice.

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  • Are you accepting new patients?
  • Do you accept my specific insurance plan?
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Insurance participation and appointment availability are not established by these public records.

Practice location

1795 Alysheba Way Ste 1103
Lexington, KY 40509-2282
Professional details: NPI, taxonomy & registry record
NPI1003943424
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Registry details

Primary taxonomy
Specialty details in registry
Taxonomy code
320600000X
Enumeration date
Feb 27, 2007
Record updated
Jun 8, 2016
More registry details
Provider type
Organization · Type 2

Reported taxonomies and licenses

Specialty details in registry

251B00000X

Specialty details in registry

251C00000X

Specialty details in registry

251S00000X

Specialty details in registry

261QD1600X

Specialty details in registry

320600000X · Primary

Specialty details in registry

320900000X

Specialty details in registry

385HR2060X

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

1795 Alysheba Way Ste 1103
Lexington, KY 40509-2282
Phone
(859) 983-8729
Fax
(859) 259-2012
Mailing address
1795 ALYSHEBA WAY STE 1103

LEXINGTON, KY 405092282
Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

Information may be outdated or incomplete. Confirm details directly with the practice. HCPList is an independent directory and is not affiliated with CMS.

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