Basic Information
Provider Information
NPI: 1538126552
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: COHEN
FirstName: RICHARD
MiddleName: H
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 91345
Address2:  
City: LOUISVILLE
State: KY
PostalCode: 402910345
CountryCode: US
TelephoneNumber: 5024732100
FaxNumber:  
Practice Location
Address1: 4004 DUPONT CIR
Address2:  
City: LOUISVILLE
State: KY
PostalCode: 402074819
CountryCode: US
TelephoneNumber: 5028966428
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/26/2006
LastUpdateDate: 10/11/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X23373KYY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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