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Organization

KENNETH R. HAUSWALD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KENNETH R HAUSWALD M.D. (OWNER)
(606) 920-9813
Entity
Organization

Contact information

Practice address
400 SAINT CHRISTOPHER DR, ASHLAND, KY 41101-7022
(606) 833-0088
(606) 833-0130
Mailing address
400 SAINT CHRISTOPHER DR, ASHLAND, KY 41101-7022
(606) 833-0088
(606) 833-0130

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
16406
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000215221
ANTHEM BC/BS
KY
05
0385104
OH
05
64164064
KY
Enumeration date
11/02/2006
Last updated
04/20/2008
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