Individual
EDWARD NISBET MAXWELL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
245 FOUNTAIN CT STE 225, LEXINGTON, KY 40509-1888
(859) 257-9320
Mailing address
2333 ALUMNI PARK PLZ, SUITE 200, LEXINGTON, KY 40517-4012
(859) 257-7910
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
16278
KY
2084P0804X
Child & Adolescent Psychiatry Physician
16278
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64162787
—
KY
Enumeration date
10/23/2006
Last updated
04/07/2016
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