Organization
GASTROENTEROLOGY SPECIALISTS OF LEXINGTON
Active
Organization
GASTROENTEROLOGY SPECIALISTS OF LEXINGTON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TINA WILLOUGHBY M.D. (OWNER/PARTNER)
(859) 278-8400
Entity
Organization
Contact information
Practice address
1401 HARRODSBURG RD, SUITE C305, LEXINGTON, KY 40504-3751
(859) 278-8400
(859) 276-3700
Mailing address
1401 HARRODSBURG RD, SUITE C305, LEXINGTON, KY 40504-3751
(859) 278-8400
(859) 276-3700
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000222477
ANTHEM BCBS
KY
01
—
1196008
CHA
KY
01
—
6800084
UNITED HEALTHCARE
KY
01
—
7059026
AETNA
KY
Enumeration date
08/25/2006
Last updated
08/22/2020
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