Pearson, Kenneth Randal

Pearson, Kenneth Randal is an individual health care provider with primary practice located at 9880 Angies Way Ste 400 , Louisville KY 40241-2850. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Pearson, Kenneth Randal can be contacted via phone (502) 394-6500.

Contact Information

Primary practice address
9880 Angies Way Ste 400 Louisville KY 40241-2850
Phone: (502) 394-6500
Fax: (502) 394-1920
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 39864 Kentucky

Profile Details

NPI number 1215029103
LBN Legal business name Pearson, Kenneth Randal
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 28th, 2006
Last updated Sep 14th, 2021 - about 4 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 1215029103 NPPES
Kentucky MEDICAID 64115017
Kentucky Other 000000501261
Kentucky Other 50009443

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