Basic Information
| Provider Information | |||||||||
| NPI: | 1790740991 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AUFOX | ||||||||
| FirstName: | WILLIAM | ||||||||
| MiddleName: | E. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 776351 | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606776351 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5022725395 | ||||||||
| FaxNumber: | 5022725339 | ||||||||
| Practice Location | |||||||||
| Address1: | 2355 POPLAR LEVEL RD | ||||||||
| Address2: | STE 200-A | ||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402171395 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5026367444 | ||||||||
| FaxNumber: | 5026367340 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/19/2006 | ||||||||
| LastUpdateDate: | 09/14/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/14/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 22150 | KY | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0252847 | 01 | KY | CIGNA / NCMA | OTHER | 2447390000 | 01 | KY | PASSPORT ADVANTAGE / NCMA | OTHER | 000014952W | 01 | KY | HUMANA / NCMA | OTHER | 50006108 | 01 | KY | PASSPORT / NCMA | OTHER | 64221500 | 05 | KY | MEDICAID | 00000352530 | 01 | KY | ANTHEM / NCMA | OTHER | 046854 | 01 | KY | SIHO / NCMA | OTHER | P00181540 | 01 | KY | RAILROAD MEDICARE | OTHER | 200505800 | 05 | IN | MEDICAID |