Individual
KENNETH A GLAVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD PHD
Contact information
Practice address
20 MEDICAL VILLAGE DR, STE 132, EDGEWOOD, KY 41017
(859) 578-5880
(859) 578-5881
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(859) 578-5880
(859) 578-5881
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
28334
KY
208600000X
Surgery Physician
35079176G
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2548256
—
OH
05
—
64283344
—
KY
Enumeration date
04/25/2006
Last updated
08/31/2018
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