Provider Demographics
NPI:1558564633
Name:KENNEY, NICHOLAS ALLEN (MD)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:ALLEN
Last Name:KENNEY
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Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 950248
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40295-0248
Mailing Address - Country:US
Mailing Address - Phone:502-489-5730
Mailing Address - Fax:502-489-5753
Practice Address - Street 1:1023 NEW MOODY LN
Practice Address - Street 2:SUITE 102
Practice Address - City:LA GRANGE
Practice Address - State:KY
Practice Address - Zip Code:40031-9177
Practice Address - Country:US
Practice Address - Phone:502-222-0598
Practice Address - Fax:502-222-7446
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2020-12-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY45177207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine