Provider Demographics
NPI:1639189848
Name:KINTS, GEERTRUIDA (MD)
Entity Type:Individual
Prefix:
First Name:GEERTRUIDA
Middle Name:
Last Name:KINTS
Suffix:
Gender:F
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 281
Mailing Address - Street 2:
Mailing Address - City:GREENUP
Mailing Address - State:KY
Mailing Address - Zip Code:41144-0281
Mailing Address - Country:US
Mailing Address - Phone:606-473-7359
Mailing Address - Fax:
Practice Address - Street 1:2301 LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-2873
Practice Address - Country:US
Practice Address - Phone:606-473-7359
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY32940207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64329402Medicaid
KY0048416000Medicaid
KY2068293Medicaid
KY0094320Medicare ID - Type Unspecified
KY2068293Medicaid