Individual
DR. RENATO V LAROCCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
315 E BROADWAY, LOUISVILLE, KY 40202-3700
(502) 629-2500
(502) 629-2055
Mailing address
1930 BISHOP LN, SUITE 1017, LOUISVILLE, KY 40218-1921
(502) 272-5754
(502) 272-5339
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
01038333A
IN
207RX0202X
Medical Oncology Physician
Primary
27078
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000051747
ANTHEM
—
05
—
100360120A
—
IN
01
—
1063885
PASSPORT
—
05
—
64270788
—
KY
01
—
90001964
RAILROAD MEDICARE
—
Enumeration date
02/08/2006
Last updated
10/16/2019
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