Individual
LARRY KETNER WEST
Active
Individual
LARRY KETNER WEST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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
Update your record
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