| Beaumont Psychiatry Pllc | |
|
3070 Lakecrest Cir Suite 400, Pmb197 Lexington KY 40513-1937 | |
| (859) 737-0904 | |
| (859) 737-0902 |
| Full Name | Beaumont Psychiatry Pllc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 3070 Lakecrest Cir, Lexington, Kentucky |
| Authorized Official Name and Position | Cletus Savio Carvalho (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 8592633888 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Beaumont Psychiatry Pllc 3070 Lakecrest Cir Suite 400, Pmb 197 Lexington KY 40513-1937 Ph: () - | Beaumont Psychiatry Pllc 3070 Lakecrest Cir Suite 400, Pmb197 Lexington KY 40513-1937 Ph: (859) 737-0904 |
| NPI Number | 1457736910 |
|---|---|
| Provider Enumeration Date | 07/27/2015 |
| Last Update Date | 06/14/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457736910 | NPI | - | NPPES |
| 64059330 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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