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Individual

CHRISTIAN D KONSAVAGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
299A GLASGOW RD, BURKESVILLE, KY 42717-9696
(270) 864-2555
(270) 864-3777
Mailing address
896 POTTERS CREEK RD, BURKESVILLE, KY 42717-7638
(270) 433-6475

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
KY37254
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0176477
BLUE CROSS
KY
05
64058860
KY
Enumeration date
06/24/2006
Last updated
01/13/2011
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