| Patriot One Primary Care PSC | |
|
989 Governors Ln Ste 140 Lexington KY 40513-1174 | |
| (859) 447-8014 | |
| Not Available |
| Full Name | Patriot One Primary Care PSC |
|---|---|
| Speciality | General Practice |
| Location | 989 Governors Ln Ste 140, Lexington, Kentucky |
| Authorized Official Name and Position | Janine Lippert (NURSE PRACTITIONER) |
| Authorized Official Contact | 8594334661 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Patriot One Primary Care PSC 989 Governors Ln Ste 220 Lexington KY 40513-1175 Ph: (859) 447-8014 | Patriot One Primary Care PSC 989 Governors Ln Ste 140 Lexington KY 40513-1174 Ph: (859) 447-8014 |
| NPI Number | 1114660735 |
|---|---|
| Provider Enumeration Date | 04/20/2022 |
| Last Update Date | 08/02/2022 |
| Certification Date | 08/02/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114660735 | NPI | - | NPPES |
| 7100137000 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | () | Primary |
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