# MARY JANE LAGREW, M.D., LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1427203454
- **Authorized official:** DR. MARY J LAGREW M.D. (OWNER)
- **Authorized official phone:** (859) 277-7920

## Contact information

- **Practice address:** 1780 NICHOLASVILLE RD, SUITE 203, LEXINGTON, KY 40503-1400
- **Practice address phone:** (859) 277-7920
- **Practice address fax:** (859) 278-9279
- **Mailing address:** 1780 NICHOLASVILLE RD, SUITE 203, LEXINGTON, KY 40503-1400
- **Mailing address phone:** (859) 277-7920
- **Mailing address fax:** (859) 278-9279

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2080A0000X | Pediatric Adolescent Medicine Physician | 20177 | KY | Yes |

## Other

- **Enumeration date:** 11/18/2008
- **Last updated:** 11/18/2008