Healthcare Provider Details

I. General information

NPI: 1083077002
Provider Name (Legal Business Name): KELSEY A COYLE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KELSEY A FIELD MD

II. Dates (important events)

Enumeration Date: 03/29/2016
Last Update Date: 03/01/2023
Certification Date: 03/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3130 MAPLELEAF DR STE 170
LEXINGTON KY
40509-1308
US

IV. Provider business mailing address

9800 SHELBYVILLE RD STE 220
LOUISVILLE KY
40223-2992
US

V. Phone/Fax

Practice location:
  • Phone: 859-263-1900
  • Fax: 855-656-7325
Mailing address:
  • Phone: 502-429-8585
  • Fax: 855-656-7325

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number52485
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: