Provider Demographics
NPI:1861449837
Name:KAZEE, DAVID W (PT)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:W
Last Name:KAZEE
Suffix:
Gender:M
Credentials:PT
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 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 1:1051 NEWTOWN PIKE
Practice Address - Street 2:SUITE H-J
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40511-1235
Practice Address - Country:US
Practice Address - Phone:859-253-0758
Practice Address - Fax:859-253-0890
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY002072225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000385850OtherBC/BS
KY961108Medicare ID - Type UnspecifiedMEDICARE #