Individual
ROSS F MICCICHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
501 E BROADWAY STE 270, LOUISVILLE, KY 40202-2040
(502) 588-4740
Mailing address
500 S PRESTON ST RM 305, LOUISVILLE, KY 40202-1702
(502) 852-8696
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
01092561A
IN
208800000X
Urology Physician
Primary
58926
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300088159
—
IN
05
—
7100715760
—
KY
Enumeration date
04/18/2017
Last updated
10/09/2025
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