Individual
DR. PHILLIP LEE KISER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1400 GRAND AVE, NEWPORT, KY 41071-2570
(859) 905-3070
(859) 441-1348
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(859) 905-3070
(859) 441-1348
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
00046836
WA
207Q00000X
Family Medicine Physician
Primary
40616
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000511094
ANTHEM
KY
01
—
40616
MEDICAL LICENSE
KY
05
—
7100015240
—
KY
Enumeration date
09/13/2006
Last updated
03/27/2024
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