Individual
CRYSTAL HAMILTON MCMAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4003 KRESGE WAY, STE 115, LOUISVILLE, KY 40207-4652
(502) 897-8163
(502) 897-8052
Mailing address
PO BOX 950248, LOUISVILLE, KY 40295-0248
(502) 489-5730
(502) 489-5753
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
42203
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000651185
ANTHEM
KY
01
—
50027952
PASSPORT
KY
05
—
7100059430
—
KY
Enumeration date
04/12/2007
Last updated
12/09/2020
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