Individual
DR. STEPHEN J KAVKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4001 KRESGE WAY, SUITE 315, LOUISVILLE, KY 40207-4640
(502) 216-3700
Mailing address
4001 KRESGE WAY, SUITE 315, LOUISVILLE, KY 40207-4640
(502) 216-3700
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
33550
KY
2082S0099X
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
33550
KY
2082S0105X
Surgery of the Hand (Plastic Surgery) Physician
33550
KY
2086S0105X
Surgery of the Hand (Surgery) Physician
33550
KY
2086S0122X
Plastic and Reconstructive Surgery Physician
33550
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000048441
BLUE CROSS
KY
01
—
1051839
PASSPORT
KY
01
—
240006152
RAILROAD MEDICARE
KY
01
—
4409578
AETNA
KY
01
—
50019069
PASSPORT INDIVIDUAL ID #
KY
05
—
64353501
—
KY
Enumeration date
01/23/2007
Last updated
02/04/2014
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