KENNETH BAZYDLO
Individual Provider (NPI-1)
Active
Family Medicine
Provider Information
- NPI Number
1558854174- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 413 SOUTH LOOP ROAD, EDGEWOOD, KY, 410175446
- Phone
- (859) 301-3800
- Fax
- (859) 301-3987
Specialties & Taxonomies
Family Medicine
Primary License: KY #TP195
Family Medicine
License: PA #MT215774