Livesay, Kenneth W
Livesay, Kenneth W is an sole proprietor health care provider with primary practice located at 1013 N Dupont Sq Ste B , Louisville KY 40207-4612. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery, Dental Providers / Oral and Maxillofacial Surgery. Dental Providers / Oral and Maxillofacial Surgery is his primary health care specialty. Livesay, Kenneth W can be contacted via phone (502) 897-5282.Contact Information
Primary practice address
1013 N Dupont Sq Ste B
Louisville KY 40207-4612
Phone: (502) 897-5282
Fax: (502) 896-6714
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery | 204E00000X | 8186 | Kentucky |
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | 8186 | Kentucky |
Profile Details
| NPI number | 1558390724 |
|---|---|
| LBN Legal business name | Livesay, Kenneth W |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 1st, 2006 |
| Last updated | Sep 17th, 2019 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1558390724 | NPPES |
| Kentucky | MEDICAID | 64106420 |
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