Individual
SHANE TRAVIS KISER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
250 KISER CEM RD, OLIVE HILL, KY 41164-9809
(606) 780-5500
(606) 783-7281
Mailing address
250 KISER CEM RD, OLIVE HILL, KY 41164-9809
(606) 780-5500
(606) 783-7281
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2034
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100394790
—
KY
01
—
PA2034
KY MEDICAL LICENSE
KY
Enumeration date
10/07/2015
Last updated
10/10/2025
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