Individual
KEVIN A O'KOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3900 KRESGE WAY STE 44, LOUISVILLE, KY 40207-4681
(502) 897-6700
(502) 897-6704
Mailing address
3900 KRESGE WAY STE 44, LOUISVILLE, KY 40207-4681
(502) 897-6700
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
33122
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000189866
ANTHEM FACET NUMBER
KY
05
—
1054637
—
KY
05
—
64331226
—
KY
Enumeration date
06/30/2005
Last updated
12/13/2023
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