Individual
JAY A LILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3205 SUMMIT SQUARE PL STE 100, LEXINGTON, KY 40509-2636
(859) 335-9041
Mailing address
3205 SUMMIT SQUARE PL STE 100, LEXINGTON, KY 40509-2636
(859) 335-9041
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
01094
WV
363A00000X
Physician Assistant
Primary
PA988
KY
Other
Enumeration date
03/12/2007
Last updated
07/08/2007
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