Healthcare Provider Details
I. General information
NPI: 1437380524
Provider Name (Legal Business Name): NORTHERN KENTUCKY INDEPENDENT HEALTH DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/06/2009
Last Update Date: 08/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
101 E 4TH ST
NEWPORT KY
41071-1615
US
IV. Provider business mailing address
610 MEDICAL VILLAGE DR
EDGEWOOD KY
41017-3416
US
V. Phone/Fax
- Phone: 859-341-4264
- Fax: 859-578-3689
- Phone: 859-341-4264
- Fax: 859-578-3689
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251K00000X |
| Taxonomy | Public Health or Welfare Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
STEVEN
R
KATKOWSKY
Title or Position: DISTRICT DIRECTOR HEALTH
Credential: M.D.
Phone: 859-341-4264