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Individual

ROSS WADE COTTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
11518 MAIN ST, LOUISVILLE, KY 40243-1316
(270) 229-6402
Mailing address
1300 CARDINAL DR UNIT 408, LOUISVILLE, KY 40213-1382
(502) 759-2103

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
25225
KY
207LA0401X
Addiction Medicine (Anesthesiology) Physician
2015090
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0516862
MEDICARE PTAN
KY
01
200027380
INDIANA MEDICAID
IN
01
64252257
KENTUCKY MEDICAID
KY
01
P00355889
MEDICARE RAIL ROAD PTAN
KY
Enumeration date
05/12/2006
Last updated
02/04/2020
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