Individual
DR. SHANE JACOB KIBBE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
209 HIGH POINT CT, MOUNT WASHINGTON, KY 40047-5511
(502) 834-5676
(833) 700-1693
Mailing address
PO BOX 33149, BELFAST, ME 04915-0609
(888) 488-8289
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
R2958
KY
207X00000X
Orthopaedic Surgery Physician
Primary
50338
KY
207X00000X
Orthopaedic Surgery Physician
R2958
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01080524A
LICENSE
IN
Enumeration date
03/26/2012
Last updated
01/20/2026
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