Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QA0401X | Family Doctor - Addiction Medicine | 01061356A | IN |
N | 207QA0401X | Family Doctor - Addiction Medicine | 36961 | KY |
N | 207R00000X | Internist | 36961 | KY |
N | 111NI0900X | Internist | 36961 | KY |
Y | 207RA0401X | Internist - Addiction Medicine | 36961 | KY |
NPI | 1619932084 |
---|---|
Provider Name | Richard H Cales |
First Address | Louisville, KY 40295-0001 |
Second Address | Louisville, KY 40219-4156 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2006 |
Last Update Date | 15/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000001064309 | ANTHEM (01) | KY |
200800610 | (05) | IN |
7100064620 | (05) | KY |
A43213 | (02) | KY |