Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 00125 | KY |
Y | 222Z00000X | Podiatrist | 00125 | KY |
N | 111NR0200X | Radiology | K0125 | KY |
N | 213ER0200X | Radiology | K0125 | KY |
N | 213ES0131X | Foot Surgery | 00125 | KY |
NPI | 1497752612 |
---|---|
Provider Name | Robert G Mchendrix III |
First Address | Erlanger, KY 41018-1866 |
Second Address | Erlanger, KY 41018-1866 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2005 |
Last Update Date | 03/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000033272 | ANTHEM BCBS (01) | KY |
0245354 | (05) | OH |
0247710001 | MEDICARE DME (01) | KY |
27-80420 | UNITED HEALTHCARE (01) | KY |
406480106 | RAILROAD MEDICARE UHC (01) | KY |
80001258 | (05) | KY |
958792 | AETNA (01) | KY |
K0125 | HUMANA/CHOICE CARE (01) | KY |
T53912 | (02) | KY |