Provider Demographics
NPI:1699084731
Name:LEXINGTON UNIQUE CARE INC
Entity type:Organization
Organization Name:LEXINGTON UNIQUE CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JON
Authorized Official - Middle Name:S
Authorized Official - Last Name:DEMOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-230-5485
Mailing Address - Street 1:2220 NICHOLASVILLE RD
Mailing Address - Street 2:UNIT 110-318
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-2449
Mailing Address - Country:US
Mailing Address - Phone:859-230-5485
Mailing Address - Fax:
Practice Address - Street 1:2628 WILHITE DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503
Practice Address - Country:US
Practice Address - Phone:859-230-5485
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-06
Last Update Date:2010-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY21889208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Multi-Specialty