Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 21143 | KY |
NPI | 1023099066 |
---|---|
Provider Name | Kenneth Mcleish |
First Address | Louisville, KY 40202-2043 |
Second Address | Louisville, KY 40202-1715 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
64211436 | (05) | KY |
C66613 | (02) | KY |