Individual
JOHN LUCAS KIESEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10510 LAGRANGE RD, LOUISVILLE, KY 40223-1277
(502) 253-7317
(502) 253-7477
Mailing address
720 BLANKENBAKER LN, LOUISVILLE, KY 40207-1040
(502) 897-1639
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
14805
KY
Other
Enumeration date
02/13/2007
Last updated
07/08/2007
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