Provider Demographics
NPI:1194923490
Name:KINGERY, JOE EAGLE (DO)
Entity type:Individual
Prefix:DR
First Name:JOE
Middle Name:EAGLE
Last Name:KINGERY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 SYCAMORE ST
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41501-9118
Mailing Address - Country:US
Mailing Address - Phone:606-218-5446
Mailing Address - Fax:
Practice Address - Street 1:184 S MAYO TRL
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501-1518
Practice Address - Country:US
Practice Address - Phone:606-430-2213
Practice Address - Fax:606-432-0336
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-07
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY03109207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine