Individual
KENNETH MCLEISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
615 S PRESTON ST, LOUISVILLE, KY 40202-1715
(502) 852-5757
(502) 852-7643
Mailing address
501 E BROADWAY, LOUISVILLE, KY 40202-2043
(502) 589-4856
(502) 589-5093
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
21143
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64211436
—
KY
Enumeration date
11/08/2005
Last updated
07/08/2007
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