Individual
KEVIN D. CONNELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 MEDICAL VILLAGE DR, EDGEWOOD, KY 41017-3403
(859) 301-8074
(859) 301-4945
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(859) 344-5555
(859) 344-5552
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
40133
KY
208M00000X
Hospitalist Physician
Primary
40133
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
209914610
—
IN
05
—
2678400
—
OH
05
—
64127095
—
KY
Enumeration date
07/26/2006
Last updated
04/26/2023
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