Individual
WILLIAM BENJAMIN KIBLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
700 BOB O LINK DR, LEXINGTON, KY 40504-3756
(859) 258-8575
(859) 258-8562
Mailing address
700 BOB O LINK DR, LEXINGTON, KY 40504-3756
(859) 258-8575
(859) 258-8562
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
18922
KY
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
18922
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36000818
ASC MEDICAID GROUP#
KY
01
—
37903705
MEDICAID LAB GROUP#
KY
01
—
4000501
MEDICARE LAB GROUP#
KY
05
—
64189228
—
KY
01
—
ASC 1019
ASC MEDICARE GROUP#
KY
01
—
CB5773
RR MEDICARE GROUP
GA
Enumeration date
07/14/2006
Last updated
11/02/2007
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