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General NPI Number Information
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NPI Number | 1215067988
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Entity Type | Individual
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Provider Name | KENNETH A THIELMEIER M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 01/07/2014
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Provider Practice Location Address
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Address Line | 1 AUDUBON PLAZA DR
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City | LOUISVILLE
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State | KY
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Zip | 40217-1318
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Country | US
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Telephone | 502-636-7160
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Fax | 502-636-8760
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Provider Business Mailing Address
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Address Line | 425 LEWIS HARGETT CIR
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City | LEXINGTON
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State | KY
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Zip | 40503-3590
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Country | US
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Telephone | 859-268-1030
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Fax | 859-269-4120
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 26716
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License Number State | KY
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