Provider Demographics
NPI:1639550908
Name:KINCAID, RALPH (OTR/L)
Entity Type:Individual
Prefix:
First Name:RALPH
Middle Name:
Last Name:KINCAID
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 ADAMS LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-8765
Mailing Address - Country:US
Mailing Address - Phone:859-358-7262
Mailing Address - Fax:
Practice Address - Street 1:133 ADAMS LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-8765
Practice Address - Country:US
Practice Address - Phone:859-358-7262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-12
Last Update Date:2015-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR0157171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor