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Individual

KENNETH BAZYDLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
413 SOUTH LOOP ROAD, EDGEWOOD, KY 41017-5446
(859) 301-3800
(859) 301-3987
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(859) 301-3800
(859) 301-3987

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MT215774
PA
207Q00000X
Family Medicine Physician
Primary
TP195
KY

Other

Enumeration date
06/08/2018
Last updated
01/12/2026
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