Organization
NEPHROLOGY CONSULTANTS OF WESTERN KENTUCKY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IVAN D ROGINEK MD (SOLE MEMBER)
(270) 632-4221
Entity
Organization
Contact information
Practice address
1717 HIGH ST, SUITE 2A, HOPKINSVILLE, KY 42240-6300
(270) 632-4221
(270) 885-2041
Mailing address
1717 HIGH ST, SUITE 2A, HOPKINSVILLE, KY 42240-6300
(270) 632-4221
(270) 885-2041
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000599078
ANTHEM BCBS
KY
05
—
7100045160
—
KY
Enumeration date
07/10/2008
Last updated
02/05/2009
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