Provider Demographics
NPI:1316213911
Name:DR. KATHRYN LEFEVERS
Entity Type:Organization
Organization Name:DR. KATHRYN LEFEVERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR
Authorized Official - Prefix:MISS
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:D
Authorized Official - Last Name:LEFEVERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-337-6297
Mailing Address - Street 1:850 RIVERVIEW RD
Mailing Address - Street 2:3RD FLOOR PCH
Mailing Address - City:PINEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40977-1430
Mailing Address - Country:US
Mailing Address - Phone:606-337-6297
Mailing Address - Fax:606-337-6292
Practice Address - Street 1:850 RIVERVIEW RD
Practice Address - Street 2:3RD FLOOR PCH
Practice Address - City:PINEVILLE
Practice Address - State:KY
Practice Address - Zip Code:40977-1430
Practice Address - Country:US
Practice Address - Phone:606-337-6297
Practice Address - Fax:606-337-6292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-28
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY7050122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty