Individual
MR. KEVIN THOMAS KAVANAGH
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
402 BOGLE ST, STE 310, SOMERSET, KY 42503
(606) 679-7426
(606) 679-7745
Mailing address
402 BOGLE ST, STE 3, SOMERSET, KY 42503
(606) 679-7426
(606) 679-7745
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
28780
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000049894
ANTHEM BCBS
KY
05
—
64287808
—
KY
Enumeration date
03/30/2006
Last updated
07/08/2007
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