Organization
LEXINGTON INFECTIOUS DISEASE CONSULTANTS PSC
Active
Organization
LEXINGTON INFECTIOUS DISEASE CONSULTANTS PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK J DOUGHERTY (PRESIDENT)
(859) 277-4005
Entity
Organization
Contact information
Practice address
1720 NICHOLASVILLE RD, STE 602, LEXINGTON, KY 40503-1404
(859) 277-4005
(859) 278-2507
Mailing address
1720 NICHOLASVILLE RD, STE 602, LEXINGTON, KY 40503-1404
(859) 277-4005
(859) 278-2507
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363LC0200X
Critical Care Medicine Nurse Practitioner
—
—
Other
Enumeration date
01/11/2007
Last updated
06/07/2013
Update your record
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