Individual
FRED P KINNICUTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
415 GIBSON LN, RICHMOND, KY 40475-2577
(859) 626-5030
Mailing address
1351 NEWTOWN PIKE BLDG 1, LEXINGTON, KY 40511-1277
(859) 253-1686
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
32340
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790731081
—
KY
Enumeration date
01/11/2007
Last updated
06/01/2022
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