Fougnie, Kirk A

Fougnie, Kirk A is an individual health care provider with primary practice located at 4331 Churchman Ave Suite 101, Louisville KY 40215-1164. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Fougnie, Kirk A can be contacted via phone (502) 364-0902.

Contact Information

Primary practice address
4331 Churchman Ave Suite 101 Louisville KY 40215-1164
Phone: (502) 364-0902
Fax: (502) 364-0099
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA582 Kentucky

Profile Details

NPI number 1295734747
LBN Legal business name Fougnie, Kirk A
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 18th, 2005
Last updated Oct 19th, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295734747 NPPES
Kentucky MEDICAID 95001475
Kentucky Other 50019798

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