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Organization

2ND CHANCE

Active
Parent organization
2ND CHANCE
Other names
2nd Chance Convenient Care
Organization subpart
Yes

Provider details

NPI number
Legal business name
2ND CHANCE
Authorized official
MARVIN BISHIOP M.D. (OWNER)
(859) 368-8820
Entity
Organization

Contact information

Practice address
1420 N BROADWAY, LEXINGTON, KY 40505-3155
(859) 368-8820
Mailing address
1420 N BROADWAY, LEXINGTON, KY 40505-3155
(859) 368-8820

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary

Other

Enumeration date
11/10/2021
Last updated
11/10/2021
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