Provider Demographics
NPI:1255462727
Name:MISINAY, LEWIS MARTIN (DC)
Entity type:Individual
Prefix:DR
First Name:LEWIS
Middle Name:MARTIN
Last Name:MISINAY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1113 FASHION RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:DRY RIDGE
Mailing Address - State:KY
Mailing Address - Zip Code:41035-9609
Mailing Address - Country:US
Mailing Address - Phone:859-643-6100
Mailing Address - Fax:
Practice Address - Street 1:8034 S. HWY 27
Practice Address - Street 2:
Practice Address - City:BURNSIDE
Practice Address - State:KY
Practice Address - Zip Code:42519
Practice Address - Country:US
Practice Address - Phone:606-561-4357
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4652111N00000X
KY249956111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY85002004Medicaid
KY227116OtherANTHEM
KY227116OtherANTHEM
KYU87528Medicare UPIN