Individual
LARRY KETNER WEST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
911 SOUTH BY PASS ROAD, PIKEVILLE, KY 41501
(606) 432-1357
(606) 432-2457
Mailing address
PO BOX 2648, PIKEVILLE, KY 41502-2648
(606) 432-1357
(606) 432-2457
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
29989
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000047646
ANTHEM
KY
05
—
0216623000
—
WV
01
—
0958131
UMWA GROUP NUMBER
—
01
—
50001859
PASSPORT
KY
05
—
64299894
—
KY
Enumeration date
08/29/2006
Last updated
07/08/2007
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