Provider Demographics
NPI:1134314784
Name:RICKARD, KYLE ASHLEY (MD)
Entity Type:Individual
Prefix:
First Name:KYLE
Middle Name:ASHLEY
Last Name:RICKARD
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 1:14010 LACLARA WAY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40299-5088
Mailing Address - Country:US
Mailing Address - Phone:502-235-1159
Mailing Address - Fax:
Practice Address - Street 1:DEPARTMENT OF PATHOLOGY AND LABORATORY MEDICINE
Practice Address - Street 2:UNIVERSITY OF LOUISVILLE, SCHOOL OF MEDICINE
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40292-0001
Practice Address - Country:US
Practice Address - Phone:502-852-8203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-06
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program