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:
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Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558390724 NPPES
Kentucky MEDICAID 64106420

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