Individual
RICHARD A HEFNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
6580 KENWOOD CROSSINGS ROAD, CRESTWOOD, KY 40014
(502) 243-3161
(502) 243-3164
Mailing address
PO BOX 950248, LOUISVILLE, KY 40295-0248
(502) 253-1035
(502) 253-1037
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02614
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000609332
ANTHEM
KY
01
—
3711039000
PASSPORT ADVANTAGE
KY
01
—
50023695
PASSPORT
KY
05
—
64000391
—
KY
01
—
P00774983
RAILROAD MEDICARE
KY
Enumeration date
07/07/2006
Last updated
12/04/2020
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