Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 33550 | KY |
Y | 208600000X | Surgeon | 33550 | KY |
N | 2082S0105X | Plastic Hand Surgeon | 33550 | KY |
N | 2086S0105X | Surgery of the Hand | 33550 | KY |
N | 2086S0122X | Plastic and Reconstructive Surgery | 33550 | KY |
NPI | 1396899373 |
---|---|
Provider Name | Dr. Stephen J Kavka |
First Address | Louisville, KY 40207-4640 |
Second Address | Louisville, KY 40207-4640 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2007 |
Last Update Date | 04/02/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000048441 | BLUE CROSS (01) | KY |
1051839 | PASSPORT (01) | KY |
240006152 | RAILROAD MEDICARE (01) | KY |
4409578 | AETNA (01) | KY |
50019069 | PASSPORT INDIVIDUAL ID # (01) | KY |
64353501 | (05) | KY |
C41561 | (02) | KY |