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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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