Provider Demographics
NPI:1003994310
Name:SCHIKLER, KENNETH N (MD)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:N
Last Name:SCHIKLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 909
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40201-0909
Mailing Address - Country:US
Mailing Address - Phone:502-629-7702
Mailing Address - Fax:502-629-3975
Practice Address - Street 1:210 E GRAY ST
Practice Address - Street 2:STE 1000
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-3906
Practice Address - Country:US
Practice Address - Phone:502-629-7702
Practice Address - Fax:502-629-3975
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY16806208000000X, 2080P0216X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0216XAllopathic & Osteopathic PhysiciansPediatricsPediatric Rheumatology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100002050Medicaid
KY64168065Medicaid
KY01474002Medicare PIN
KY64168065Medicaid
IN100002050Medicaid