Unknown Individual – General Practice Physician, NPI 1962453530
General Practice Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
151, North Eagle Creek Drive, Lexington, Fayette County, Kentucky, 40509, United States
STE 100
LEXINGTON, KY 405091889
Phone: (859) 263-4341
Fax: (859) 263-7441
Type: Mailing
100, Trade Street, Viley, Lexington, Fayette County, Kentucky, 40511, United States
STE C
LEXINGTON, KY 405112610
Phone: (859) 231-1176
Fax: (859) 231-1186
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 40509)
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