Provider Demographics
NPI:1912092891
Name:KEDING, DAVID JAMES (DC)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JAMES
Last Name:KEDING
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:416 MILLERSBURG RD
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:KY
Mailing Address - Zip Code:40361-2145
Mailing Address - Country:US
Mailing Address - Phone:859-987-6058
Mailing Address - Fax:859-988-9794
Practice Address - Street 1:416 MILLERSBURG RD
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:KY
Practice Address - Zip Code:40361-2145
Practice Address - Country:US
Practice Address - Phone:859-987-6058
Practice Address - Fax:859-988-9794
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2016-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4192111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY85041929Medicaid
KYK029010Medicare PIN
KY85041929Medicaid