Provider Demographics
NPI:1497913552
Name:CENTRAL KENTUCKY PSYCHIATRY, PLLC
Entity Type:Organization
Organization Name:CENTRAL KENTUCKY PSYCHIATRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PIOTR
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIEBA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-238-0018
Mailing Address - Street 1:PO BOX 31
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40423-0031
Mailing Address - Country:US
Mailing Address - Phone:859-238-0018
Mailing Address - Fax:859-238-0019
Practice Address - Street 1:359 S 4TH ST STE D
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:KY
Practice Address - Zip Code:40422-2078
Practice Address - Country:US
Practice Address - Phone:859-238-0018
Practice Address - Fax:859-238-0019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-27
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY303182084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty