Lifeworks Aesthetic Center, PSC

Primary specialty

SpecialistTaxonomy code 174400000X

License

15202 Issued in KY

Legal business name

LIFEWORKS AESTHETIC CENTER, PSC

Practice address

242 Berger Rd
Paducah, KY 42003-4522

Phone

(270) 444-0119

Fax

(270) 444-9129

NPI assigned

Dec 14, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Peter A Ward, MD

Title

President

Phone

(270) 444-0119

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211328000000",
    "number": "1043372279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "242 BERGER RD",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420034522",
            "telephone_number": "270-444-0119",
            "fax_number": "270-444-9129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 BERGER RD",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420034522",
            "telephone_number": "270-444-0119",
            "fax_number": "270-444-9129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEWORKS AESTHETIC CENTER, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-14",
        "last_updated": "2008-05-21",
        "status": "A",
        "authorized_official_last_name": "WARD",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "270-444-0119",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "KY",
            "license": "15202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64095334",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Paducah, KY
• Providers in Paducah, KY by specialty
• Specialist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.