Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 34527 | KY |
NPI | 1003832866 |
---|---|
Provider Name | David R. Kielar |
First Address | Lexington, KY 40509-1805 |
Second Address | Lexington, KY 40509-1805 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2006 |
Last Update Date | 02/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
37903705 | MEDICAID LAB GROUP# (01) | KY |
4000501 | MEDICARE LAB GROUP# (01) | KY |
64354277 | (05) | KY |
CB5773 | RR MEDICARE GROUP# (01) | GA |
G53593 | (02) |