Healthcare Provider Details

I. General information

NPI: 1700791332
Provider Name (Legal Business Name): KND DEVELOPMENT 59 , LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HUNTERS GLEN ROAD 100 HUNTERS GLEN ROAD
DOTHAN AL
36303-2468
US

IV. Provider business mailing address

680 S 4TH ST
LOUISVILLE KY
40202-2407
US

V. Phone/Fax

Practice location:
  • Phone: 502-596-7358
  • Fax:
Mailing address:
  • Phone: 502-596-7358
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: LINDA L FISHER
Title or Position: DVP REVENUE CYCLE
Credential:
Phone: 502-596-7358