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General NPI Number Information
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NPI Number | 1073252375
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Entity Type | Organization
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Legal Business Name | KIBBE ORTHOPEDICS PLLC
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Dates
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Enumeration Date | 06/03/2022
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Last Update Date | 05/20/2024
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Provider Practice Location Address
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Address Line | 809 MORTON AVE STE 100
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City | BARDSTOWN
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State | KY
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Zip | 40004-2565
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Country | US
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Telephone | 502-834-5676
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Fax | 833-700-1693
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Provider Business Mailing Address
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Address Line | PO BOX 33149
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City | BELFAST
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State | ME
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Zip | 04915-0609
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Country | US
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Telephone | 888-488-8289
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Fax | 502-919-9780
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Authorized Official
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Title or Position | OWNER
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Name | SHANE KIBBE
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Credential | MD
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Telephone | 502-834-5676
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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Taxonomy #3
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number State |
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