# BIBB ADDICTION & OBESITY CENTER

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

## Provider details

- **NPI number:** 1821783259
- **Authorized official:** DAVID CARTER (BILLING MANAGER)
- **Authorized official phone:** (859) 737-0904

## Contact information

- **Practice address:** 365 WALLER AVE STE 100, LEXINGTON, KY 40504-2924
- **Practice address phone:** (859) 309-1829
- **Mailing address:** 365 WALLER AVE STE 100, LEXINGTON, KY 40504-2924

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RA0401X | Addiction Medicine (Internal Medicine) Physician | — | NULL | Yes |
| 207RA0401X | Addiction Medicine (Internal Medicine) Physician | — | — | Yes |
| 207RB0002X | Obesity Medicine (Internal Medicine) Physician | — | NULL | — |
| 207RB0002X | Obesity Medicine (Internal Medicine) Physician | — | — | — |

## Other

- **Enumeration date:** 04/11/2023
- **Last updated:** 04/11/2023