Individual
DR. MAX L IRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1169 EASTERN PKWY, SUITE 1234, LOUISVILLE, KY 40217-1417
(502) 456-3990
(502) 456-3998
Mailing address
PO BOX 950202, LOUISVILLE, KY 40295-0202
(502) 272-5100
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
17516
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000692773
ANTHEM- NCMA
KY
05
—
201014360
—
IN
01
—
2537920
CIGNA- NMCA
KY
01
—
50031968
PASSPORT- NMCA
KY
05
—
64175169
—
KY
01
—
P00869556
RAILROAD MEDICARE- NCMA
KY
Enumeration date
01/05/2007
Last updated
01/12/2016
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