Healthcare Provider Details

I. General information

NPI: 1407417801
Provider Name (Legal Business Name): KYRA N FOLKERT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2019
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 NEW HARTFORD RD
OWENSBORO KY
42303-1320
US

IV. Provider business mailing address

545 BARNHILL DR
INDIANAPOLIS IN
46202-5112
US

V. Phone/Fax

Practice location:
  • Phone: 270-683-3720
  • Fax: 270-686-7331
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number4351045645
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number61471
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number01094168A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: