Provider Demographics
NPI:1639319643
Name:NORTHERN KENTUCKY INDEPENDENT DISTRICT HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:NORTHERN KENTUCKY INDEPENDENT DISTRICT HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DISTRICT DIRECTOR OF HEALTH
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:R
Authorized Official - Last Name:KATKOWSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:859-341-4264
Mailing Address - Street 1:610 MEDICAL VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:EDGEWOOD
Mailing Address - State:KY
Mailing Address - Zip Code:41017-3416
Mailing Address - Country:US
Mailing Address - Phone:859-341-4264
Mailing Address - Fax:859-578-3689
Practice Address - Street 1:150 ADELA AVE
Practice Address - Street 2:
Practice Address - City:LUDLOW
Practice Address - State:KY
Practice Address - Zip Code:41016-1469
Practice Address - Country:US
Practice Address - Phone:859-431-7242
Practice Address - Fax:859-578-3689
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-03
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare