Individual
JESSICA L KAVANAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2250 LEESTOWN RD, LEXINGTON, KY 40511-1052
(859) 233-4511
(859) 281-3801
Mailing address
2250 LEESTOWN RD, LEXINGTON, KY 40511-1052
(859) 233-4511
(859) 281-3801
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
35-094893
OH
208100000X
Physical Medicine & Rehabilitation Physician
Primary
48980
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201002790
—
IN
05
—
3040999
—
OH
05
—
7100116160
—
KY
Enumeration date
05/29/2008
Last updated
12/11/2024
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