Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Commonwealth of Kentucky

Organization Neurology Physician · NPI 1750552857

Commonwealth of Kentucky provides Neurology Physician services in Lexington, Kentucky. Licensed in Kentucky. Registered with an NPI since 2008.

Licensed in
KY
In the registry since
2008
Specialties on file
6
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Practice location Address checks out

1350 Bull Lea Rd
Lexington, KY 40511-1247
Phone: (859) 246-8000
Fax: (859) 246-8043
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Neurology Physician (primary) Taxonomy 2084N0400X (KY)
Neurology Physician Taxonomy 2084N0400X
Psychiatry Physician Taxonomy 2084P0800X
General Practice Physician Taxonomy 208D00000X
Physician Assistant Taxonomy 363A00000X
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X

Record details

NPI number1750552857
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationCommonwealth of Kentucky
Authorized official Jennifer Moore — Assistant Director · (502) 782-6117
Other names Eastern State Hospital
NPI enumeratedMarch 17, 2008
Last updated in NPPESOctober 30, 2024
Certification dateOctober 30, 2024
Mailing address1350 Bull Lea Rd, Lexington, KY 40511-1247

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