Individual
DR. PAUL R KENSICKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
550 S JACKSON ST, LOUISVILLE, KY 40202-1622
(502) 852-1931
(502) 852-5098
Mailing address
PO BOX 3367, LOUISVILLE, KY 40201-3367
(502) 813-6655
(502) 813-6665
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
33805
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0026956
PTAN
—
05
—
200825440
—
IN
05
—
64338056
—
KY
01
—
79959
TRICARE
KY
Enumeration date
01/27/2006
Last updated
03/26/2010
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