Organization
KIDS HEALTH SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANDREW STIVERS (PRESIDENT)
(502) 229-1744
Entity
Organization
Contact information
Practice address
30 MAIN ST, SHELBYVILLE, KY 40065-1020
(502) 229-1744
Mailing address
100 DIAGNOSTIC DR, FRANKFORT, KY 40601-6524
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
40801
KY
208000000X
Pediatrics Physician
43264
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
KY
Enumeration date
06/10/2013
Last updated
06/10/2013
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