Commonwealth of Kentucky

Organization Active NPI Medical Physician Assistant · Lexington, KY

NPI 1972054443 · NPPES record last updated Oct 20, 2016

Key facts

NPI
1972054443
Entity type
Organization (NPI type 2)
Primary specialty
Medical Physician Assistant 363AM0700X
Legal business name
COMMONWEALTH OF KENTUCKY
Practice address
1350 Bull Lea Rd
Lexington, KY 40511-1247
Phone
(859) 246-8000
Fax
(859) 246-8043
NPI assigned
Oct 20, 2016
Organization subpart
No

Authorized official

Name
Carrie Rudzik
Title
Cfo
Phone
(859) 246-8204

Corporate family (same tax ID) 15

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
West Liberty Elementary (126 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant
Group: 193400000X SINGLE SPECIALTY GROUP
363AM0700X Yes

Addresses

Primary practice location

1350 Bull Lea Rd
Lexington, KY 40511-1247

Mailing address

1350 Bull Lea Rd
Lexington, KY 40511-1247
Phone (859) 246-8000

Other names

  • ESH Physician Assistant Group Doing business as

Other providers in Lexington, KY

All providers in Lexington, KY · Medical Physician Assistant in Kentucky

Sources for this page

Verify at the official NPI Registry.