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Organization

WELLINGTON PROVIDER GROUP PC

Active
Parent organization
WELLINGTON PROVIDER GROUP PC
Organization subpart
Yes

Provider details

NPI number
Legal business name
WELLINGTON PROVIDER GROUP PC
Authorized official
BRITTANY DENNIS (BILLING/CREDENTIALING MANAGER)
(859) 518-8817
Entity
Organization

Contact information

Practice address
535 WELLINGTON WAY STE 330, LEXINGTON, KY 40503-1331
(859) 439-0399
Mailing address
535 WELLINGTON WAY STE 330, LEXINGTON, KY 40503-1331

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
208D00000X
General Practice Physician
261QG0250X
Genetics Clinic/Center
261QP2300X
Primary Care Clinic/Center
363A00000X
Physician Assistant
363L00000X
Nurse Practitioner
363LF0000X
Family Nurse Practitioner

Other

Enumeration date
01/04/2022
Last updated
05/18/2023
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