Individual
KENNETH L GERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
171 N EAGLE CREEK DR, SUITE 106, LEXINGTON, KY 40509-1801
(859) 277-9112
(859) 227-7105
Mailing address
171 N EAGLE CREEK DR, SUITE 106, LEXINGTON, KY 40509-1801
(859) 277-9112
(859) 227-7105
Taxonomy
Speciality
Code
Description
License number
State
2080P0201X
Pediatric Allergy/Immunology Physician
Primary
14056
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000045611
BLUE CROSS BLUE SHIELD
KY
05
—
64140569
—
KY
Enumeration date
07/19/2006
Last updated
07/08/2007
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