Basic Information
Provider Information
NPI: 1518306471
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LEUNG
FirstName: KENNETH
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 2379
Address2:  
City: ASHLAND
State: KY
PostalCode: 411052379
CountryCode: US
TelephoneNumber: 6064086200
FaxNumber: 6064086612
Practice Location
Address1: 613 23RD ST STE G10
Address2:  
City: ASHLAND
State: KY
PostalCode: 411012886
CountryCode: US
TelephoneNumber: 6064085864
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/24/2013
LastUpdateDate: 11/30/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/30/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X4301102716MIN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RP1001X35.137176OHN Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
207RP1001X51963KYY Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease

No ID Information.


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