| Nova Physician Group PLLC | |
|
208 Legends Ln Ste 160 Lexington KY 40505-3287 | |
| (859) 201-9870 | |
| (312) 929-0373 |
| Full Name | Nova Physician Group PLLC |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 208 Legends Ln Ste 160, Lexington, Kentucky |
| Authorized Official Name and Position | Terrence Morton (SR. MEDICAL DIRECTOR) |
| Authorized Official Contact | 3127339730 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nova Physician Group PLLC 30 W Monroe St Ste 1200 Chicago IL 60603-2420 Ph: (773) 352-1515 | Nova Physician Group PLLC 208 Legends Ln Ste 160 Lexington KY 40505-3287 Ph: (859) 201-9870 |
| NPI Number | 1619724606 |
|---|---|
| Provider Enumeration Date | 05/06/2024 |
| Last Update Date | 05/06/2024 |
| Certification Date | 05/06/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619724606 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | () | Primary |
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