Individual
BRENDON M. COUGHTRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
99 WELLPARK LANE, STE 4, CAMPBELLSVILLE, KY 42718-4919
(606) 260-8613
(859) 977-2683
Mailing address
PO BOX 21890, BELFAST, ME 04915-4115
(502) 907-0356
(502) 919-9780
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
42072
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001155521
ANTHEM PIN
—
01
—
102719KYIP
AETNA BETTER HEALTH OF KY PROVIDER ID NUMBER
KY
01
—
1563218
WELLCARE OF KY PROVIDER ID NUMBER
KY
05
—
1669514840
—
WV
01
—
2950152
UNITED HEALTHCARE PROVIDER ID NUMBER
—
05
—
300012018
—
IN
05
—
30015488600001
—
VA
01
—
3406022
CIGNA PROVIDER ID NUMBER
—
05
—
7100051000
—
KY
01
—
9276417
AETNA PROVIDER ID NUMBER
—
01
—
CS1815900343
CARESOURCE PROVIDER ID NUMBER
—
Enumeration date
02/13/2007
Last updated
01/30/2026
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us