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Individual

DR. MARK S CORNETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4123 DUTCHMANS LN STE G2, LOUISVILLE, KY 40207-4758
(502) 899-6601
(502) 899-6644
Mailing address
PO BOX 776347, CHICAGO, IL 60677-6347
(502) 588-9490
(502) 272-5116

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
28989
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000178939
ANTHEM PROVIDER NUMB
KY
01
000020583J
HUMANA PROVIDER NUMB
KY
01
1118125
PASSPORTPROVIDER NUMB
KY
01
1757375
CIGNA PROVIDER NUMBER
KY
05
200035990
IN
01
5941087
AETNA PROVIDER NUMB
KY
05
64289895
KY
01
920005753
RAILROAD MEDICARE
KY
Enumeration date
04/28/2006
Last updated
04/17/2025
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