Individual
BOB S KANOVITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
331 S 3RD ST, BARDSTOWN, KY 40004-1032
(502) 348-9206
(502) 348-6485
Mailing address
107 CRANES ROOST CT, ELIZABETHTOWN, KY 42701-3650
(270) 765-2605
(270) 766-1222
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
14160
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000317338
ANTHEM
KY
01
—
11386231
CAQH
—
05
—
30605018
—
KY
01
—
343023
TRICARE
KY
Enumeration date
05/23/2006
Last updated
07/08/2007
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