PATRIOT ONE PRIMARY CARE PSC NPI 1699410548

NPI Information

PATRIOT ONE PRIMARY CARE PSC is a medical physician assistant in Lexington, KY. PATRIOT ONE PRIMARY CARE PSC NPI is 1699410548. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

989 GOVERNORS LN STE 220
LEXINGTON, KY
ZIP 40513-175
Phone: (859) 447-8014
Fax: (859) 447-8013

The provider's authorized official is Elizabeth Mentzer .
The authorized official title is Owner and has the following contact phone number (859) 447-8014.

The CLIA number assigned to this NPI record is 18D2270238 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/4/2022 and was last updated on 8/2/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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