Gardner, Kenneth A.

Gardner, Kenneth A. is an individual health care provider with primary practice located at 150 Fairview Court , Eminence KY 40019. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / General Practice, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Gardner, Kenneth A. can be contacted via phone (502) 845-5672.

Contact Information

Primary practice address
150 Fairview Court Eminence KY 40019
Phone: (502) 845-5672
Fax: (502) 845-1402
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X 22049 Kentucky
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 22049 Kentucky

Profile Details

NPI number 1710976352
LBN Legal business name Gardner, Kenneth A.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 17th, 2005
Last updated Mar 15th, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710976352 NPPES
Kentucky MEDICAID 64220494
Kentucky Other 00000048271
Kentucky Other 00000048271
Kentucky Other 0100485

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