| Jennifer L Wilson, | |
|
3050 Harrodsburg Rd, Ste 100, Lexington, KY 40503-2747 | |
| (859) 277-6102 | |
| (859) 977-0237 |
| Full Name | Jennifer L Wilson |
|---|---|
| Gender | Female |
| Speciality | Pediatrics - Adolescent Medicine |
| Location | 3050 Harrodsburg Rd, Lexington, Kentucky |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043321748 | NPI | - | NPPES |
| 7100028860 | Medicaid | KY | |
| G52858 | Medicaid | SC | |
| 135542874A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 41107 (Kentucky) | Secondary |
| 208000000X | Pediatrics | 052858 (Georgia) | Secondary |
| 2080A0000X | Pediatrics - Adolescent Medicine | 41107 (Kentucky) | Primary |
| Entity Name | New Lexington Clinic Psc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1700803681 PECOS PAC ID: 3476457532 Enrollment ID: O20031121000103 |
| Mailing Address | Practice Location Address |
|---|---|
| Jennifer L Wilson, 1221 S Broadway, Lexington, KY 40504-2701 Ph: (859) 258-6200 | Jennifer L Wilson, 3050 Harrodsburg Rd, Ste 100, Lexington, KY 40503-2747 Ph: (859) 277-6102 |
Preeti Ramachandran, M.D. Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 800 Rose St Fl Ha4, Lexington, KY 40536 Phone: 859-323-6754 Fax: 859-323-6754 | |
Robin L Feese, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1780 Nicholasville Rd, Ste 301, Lexington, KY 40503 Phone: 859-277-6636 Fax: 859-277-1455 | |
Dr. Mina Hazem Halim Hanna, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 800 Rose St # Ms 471, Lexington, KY 40536 Phone: 248-854-3120 Fax: 859-323-8031 | |
Jacob A Bishop, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 245 Fountain Ct, Lexington, KY 40509 Phone: 859-323-6861 | |
Donna Glandon Grigsby, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 740 S Limestone, Lexington, KY 40536 Phone: 859-323-5481 | |
Dr. John Charles Vance, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1760 Nicholasville Rd, Suite 406, Lexington, KY 40503 Phone: 859-276-1221 Fax: 859-278-0047 | |
Dr. Kimberly Renee Dennis Northrip, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 740 S Limestone, J426, Lexington, KY 40536 Phone: 859-323-6426 |