Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 036-106836 | IL |
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 44711-021 | WI |
Y | 2081P2900X | Pain Medicine | 03100 | KY |
N | 2081P2900X | Pain Medicine | 060836 | GA |
NPI | 1265615546 |
---|---|
Provider Name | Dr. Steven Kent Ganzel |
First Address | Lexington, KY 40503-2925 |
Second Address | Lexington, KY 40503-2954 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/12/2007 |
Last Update Date | 29/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1265615546 | (02) | GA |
7100308400 | (05) | KY |