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Individual

KANEWELA A JAYASEKERA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
EASTERN STATE HOSPITAL, 627 W 4TH ST, LEXINGTON, KY 40508-1294
(859) 246-7558
(859) 246-7023
Mailing address
CONNECTIONS, 3479 BUCKHORN DR., LEXINGTON, KY 40515-1294
(859) 271-3812
(859) 967-1069

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
18217
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
18217
KY
01
P00022290
RR MEDICARE
KY
Enumeration date
06/26/2006
Last updated
02/12/2009
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