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Organization

ANDOVER FAMILY MEDICINE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KIRSTEN LEA COOPER M.D. (PHYSICIAN)
(859) 268-0254
Entity
Organization

Contact information

Practice address
2801 PALUMBO DR, SUITE 200, LEXINGTON, KY 40509-1317
(859) 268-0254
(859) 263-0159
Mailing address
PO BOX 55168, LEXINGTON, KY 40555-5168
(859) 268-0254
(859) 263-0159

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
33166
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000371547
ANTHEM BCBS
KY
01
1224232
CHA
KY
01
2075768
FIRST HEALTH
KY
01
5276688
AETNA
KY
05
65944324
KY
01
84146
WASAU
KY
Enumeration date
12/26/2006
Last updated
08/22/2020
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