Individual
DR. KENNETH LORNE BALCOMBE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6420 DUTCHMANS PKWY, SUITE 380, LOUISVILLE, KY 40205-3372
(502) 894-8441
(502) 894-4453
Mailing address
6420 DUTCHMANS PKWY, SUITE 380, LOUISVILLE, KY 40205-3372
(502) 894-8441
(502) 894-4453
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
28985
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000045106
BCBS
KY
01
—
000000674386
ANTHEM - NICC
KY
01
—
117555
SIHO - NICC
KY
05
—
200024650
—
IN
01
—
61-0719349
TAX ID
KY
01
—
610731823
TAX ID
—
05
—
64289853
—
KY
05
—
7100199530
—
KY
01
—
P00861077
MEDICARE RAILROAD- ICC
IN
01
—
P00861078
MEDICARE RAILROAD-ICC
KY
Enumeration date
06/21/2005
Last updated
08/23/2012
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